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Peran Komite Medik

dalam
Pelaksanaan
Program Pengendalian Resistensi Antimikroba

Dr. Dody Firmanda, Sp.A, MA
Ketua Komite Medik
RSUP Fatmawati, Jakarta
http://www.esnips.com/web/komitemedik

Disampaikan pada pertemuan Amrin (Antimicrobial Resistance of Indonesia)
Diselenggarakan oleh Direktorat Bina Medik Spesialistik Depkes RI di Hotel
Horison Bekasi 6 – 8 November 2008.
Clinical
Leadership

Gambar 1. Konsep dan Filosofi Komite Medik RS: Etika, Mutu dan Evidence-based
Medicine (EBM)
(untuk RS pendidikan)
KOMITE MEDIK: SISTEM CLINICAL GOVERNANCE, PATIENT SAFETY & CP
/ Adverse Events
Surveilans
Infeksi
Nosokomial

High Impact
Interventions
Process:
Implementation
of Patient Safety
1

5 2

3

4
Peran Komite Medik:
Menegakkan Etik dan Mutu Profesi

Program Pengendalian Resistensi Antimikroba

1. Daftar
1. Seleksi Antibiotik
Formularium RS
2. Penggunaan Antibiotik
1. Audit Medis 2. SPM/SPO 3. Penyebaran Mikroba
2. Clinical Risks 3. CP: Penyakit
Management Infeksi & Tropis
3. Safety 4. Surveilans
Infeksi
Nosokomial
5. High Impact
Interventions
Surveilans
Infeksi
Nosokomial

High Impact
Interventions
Program Pengendalian Resistensi Antimikroba
1. Daftar Formularium 1. Seleksi
2. SPM/SPO 2. Penggunaaan
3. Penyebaran

1. Surveilans
1. Audit Medis
2. High Impact Interventions
2. Clinical Risks
Management
3. Patient Clinical Pathways:
Safety Penyakit Infeksi dan Tropis

Terintegrasi secara ko-ordinasi dan ko-operasi
“span& spin ofcontrol ”
“Patched-in”
“Patched-in”
2005 -2008

MILIK KOMITE MEDIK RSUP FATMAWATI
Pola Kuman 2005
Jenis Kuman Menurut Bahan RSUP Fatmawati Jakarta
Januari - Desember 2005
Jenis Kuman Menurut Ruang
RSUP Fatmawati Jakarta
Januari - Desember 2005
Pola Kuman 2006
Gram negatif
80.8%

Gram positif
19.2%

S.typhi 0.8%
A S.rubidiae
.hinshawii
S.enteritidis
1.3% 1.0%
1.0%
K.ozaenae 1.1% C.amalunat ycus
E.gregov iae 0.2%
1.8%
P.aeruginosa
2.1%
2.4%
P .stuart ii
0.2%
S.saprophyticus S.liquifaciens
S.aureus 2.9%
3.4%
17.0%

P .mirabilis E.co li
3.6% 21.4%
S.marces ens
9.2%

K.pneumo niae Pseudo mo nas sp.
β-haemolyt icus 9.5% 21.2%
23.4%
E.aerogenes
S.epidermidis 19.9%
55.1%
Jenis Kuman Menurut Bahan RSUP Fatmawati Jakarta
Januari - Desember 2006
Jenis Kuman Menurut Ruang RSUP Fatmawati Jakarta
Januari - Desember 2006
Pola Kuman 2007
Gram negatif
74.37%

Gram pos itif
25.63%

GRAM NEGATIF
GRAM POSITIF
K . pneumoni ae S.mar cesens

11. 3% 4. 1%
S. l i qui f ac i ens
K .ozaenae
7. 3%
Pseudomonas sp. P.mi r abi l i s 3.6%

17.4% 4. 6%
Staphylo co ccu P. aer ugi nos a

s sp 2. 6%
S.aureus
0% S.β-
S.sapro phyticu 9% E . cl oac ae
haemo lyticus 1. 5%
s S.typhi
40%
22% 1. 2%

E . gr egov i ae
0.9%

C.f r eundi i
0.7%

M . mor gani i

E .aer ogenes 0. 3%

19. 5% P.vul gar i s
0. 3%
S.epidermidis
29% K.oxytoca
0. 2%

E.col i
S. r ubi di ae E. sakazaki i
23.5% 0. 2% 0.2%

S.ent er i t i di s
C.di ver sus
0. 2%
0.2%
P.stuar ti i P .r ettger i

0. 2% 0. 2%
Jenis Kuman Menurut Ruang RSUP Fatmawati Jakarta
Januari - Desember 2007
Pola Kuman Januari – Juni 2008
Gram ne gatif
77%

Gram pos itif
23%

P. mirabilis
GRAM NEGATIF
GRAM POSITIF 4.0%

S. liquef aciens
3.8%

E. ger goviae
2.8%
S. marcescens
Pseudomonassp. 7.5% E. cloacae
S. bet a-haemol yti c 2.6%
8.7%
28% S. rubidaea
P. aer uginosa
10.9% 2.6%
S. epi der mi di s
43% K. ozaenae
1.3%
P. Al calif aciens
K. pneumoniae 0.6%
13.3% C. f reundii
1.0%

C. diver sus
S. bet a-haem. Gr oup A
0.6%
0%
P. f luor escens
S. sapr ophyti cus
0.4%
20%
E. aggl omer ans
S. aur eus 0.4%
E.aer ogenes
S. non-haemol yti c (gamma) 6%
16.6% S. Typhi
3% 0.4%
E.coli
21.4% E.coli, ent er opat hogenic
Al caligenes sp. 0.3%
0.1%
E. sakazakii Pr ot eusvulgar is
0.3% 0.3%
Jenis Kuman Menurut Bahan RSUP Fatmawati Jakarta
Januari - Desember 2008
Jenis Kuman Menurut Ruang RSUP Fatmawati Jakarta
Januari - Desember 2008
INDIKATOR Hospital Epidemiology Infection Control 2nd ed. (Mayhall. 2001)
IADP : 6%
INDIKATOR Hospital Epidemiology Infection Control 2nd ed. (Mayhall. 2001)
Phlebitis : 5%
INDIKATOR Hospital Epidemiology Infection Control 2nd ed. (Mayhall. 2001)
ISK : 25%
INDIKATOR Hospital Epidemiology Infection Control 2nd ed. (Mayhall. 2001)
ILO : 12 %
INDIKATOR Hospital Epidemiology Infection Control 2nd ed. (Mayhall. 2001)
VAP : 50%
Golongan Lantai 4 Lantai 5 Lantai 6 Jumlah

Certriaxone Sefalosporin 87 64 73 224

Cefotaxim Sefalosporin 0 44 0 44

Ciprofloxacin Kuinolon 66 40 28 134

Meiact Sefalusponin 28 0 0 28

6 Guns

Ceftazidin Sefalosporin 18 0 4 22

Lacedim Sefalosporin 1 0 0 1

Ceftum Sefalosporin 3 0 0 3
Sistem satu pintu obat,
Penggunaan seleksi obat
antibiotika dan biaya obat
Form:
Clinical
Pathwaysof
Pneumonia
Variances
ANTIBIOTIC DRUGS

70 %

Cephalosporin 16%
Amoxycillin 14%
Peningkatan SDM
Sub Komite Pengendalian Infeksi
Komite Medik RSUP Fatmawati
6 orang
Certificate of Achievement dari Asia Pacific Society of Infection Control
1. Dr. Pratiwi Andayani, Sp.A
2. Dr. Sjafruddin, Sp.THT
3. Dra. DebbieDaniel, Apt, M.Epid.
4. Zr. Salfitriawati Arwan, SKep
5. Zr. Minarni, AMK
6. Zr. Ni Nyoman Sriadi
Langkah Berikutnya
Komite Medik
RSUP Fatmawati
PENGEMBANGAN
WORLD CLASS HOSPITALS

Dr. Dody Firmanda, Sp.A, MA
Ketua Komite Medik
RSUP Fatmawati
Jakarta
WORLD CLASS HOSPITALS
DEFINITION(S)

world-class
adj. (of a person, thing, or activity) of or among the best in the
world.

hos·pi·tal
n. 1. an institution providing medical and surgical treatment and
nursing care for sick or injured people.
2. hist. a hospice, esp. one run by the Knights Hospitallers.

© The Oxford Pocket Dictionary of Current English 2008, originally
published by Oxford University Press 2008
WHO Europe : Performance Assessment Tools for Hospitals
(PATH)
Model Komite Medik RSUP Fatmawati
PATH

dengan

ClinicalPathways
Semoga Bermanfaat

Jakarta, 7 November 2008
dodyfirmanda