Pharmaceutical Service Management (PKPO) Structure
📌 The Pharmacy Installation is mandated by Law No. 44 of 2009 to organize, coordinate, regulate, and supervise all pharmaceutical service activities, operating under a one-door system.
📌 Legal foundations include the Minister of Health Regulation (Permenkes) No. 72 of 2016 concerning pharmaceutical service standards in hospitals.
📌 Pharmaceutical services are divided into two main areas: management of pharmaceutical preparations, medical devices, and consumable medical supplies (BMHP), and clinical pharmacy services.
📌 The RSUD Bandung Kiwari Pharmacy features a central installation (2nd floor), a central warehouse (5th floor), an ER pharmacy depot, and an OR (OK) pharmacy depot.

Management of Pharmaceutical Preparations & Inventory
📌 Pharmaceutical management encompasses nine activities: selection, planning, procurement, receipt, storage, distribution, disposal/recall, control, and administration.
📌 The facility utilizes a pneumatic tube system for rapid (3-8 seconds) delivery of documents and pharmaceuticals, though it is restricted for use with narcotics or psychotropics.
📌 Thermolabile storage (like vaccines) requires twice-daily temperature monitoring using a specific temperature graph.
📌 High-Alert (LASA) medications (e.g., look-alike/sound-alike drugs, concentrated electrolytes, psychotropics) require double-checking by two different officers and are clearly labeled with red or yellow stickers.

Clinical Pharmacy Services & Safety
📌 Clinical pharmacy services include prescription review, medication history tracing, drug reconciliation, drug information, counseling, ward visits, Drug Therapy Monitoring (DTM), and monitoring of drug side effects (MESO).
📌 LASA risk factors include unclear handwriting, similar product packaging, and similar drug strengths or frequencies, categorized into 20 drugs based on similar pronunciation.
📌 Concentrated electrolytes must be clearly marked with a red sticker indicating high concentration and require reconstitution before administration, adhering to the 7 Rights of drug administration.
📌 Cytostatic drug compounding must follow aseptic technique, including mandatory PPE use, laminar air flow (LAF) activation, and disinfection steps.

Hazardous Materials and Emergency Preparedness
📌 Hazardous and Toxic Materials (B3) are stored in a dedicated room on the 5th floor, separate from the main warehouse, equipped with emergency eye wash facilities.
📌 All B3 substances must be labeled according to their Material Safety Data Sheet (MSDS), which details safety, usage, and emergency handling procedures.
📌 There are 21 Emergency Trolleys across the hospital, kept locked with a code known only to pharmacy staff to ensure readiness for code events.
📌 Expiry management in emergency trolleys uses a color-coded sticker system: Red (<4 months until expiry), Yellow (<6 months), and Green (<12 months).

Medication Error Prevention and Reporting
📌 Medication errors can occur in five stages: prescribing, transcribing (interpreting the prescription), preparation, dispensing, and administration.
📌 The classification of medication errors ranges from Category A (no error) to Category I (death), based on the severity of harm caused to the patient.
📌 Key prevention strategies include enhancing communication (using approved abbreviation lists, medication reconciliation), digitalized systems (CPOE, EHR, Barcode Medication Administration/BCMA), and system analysis using FMEA (Failure Mode and Effects Analysis).
📌 Effective communication during verbal orders requires using the NATO phonetic alphabet (e.g., Alpha, Bravo, Charlie) for spelling clarity.

Key Points & Insights
➡️ Pharmaceutical services operate under a one-door system mandated by law, ensuring centralized oversight.
➡️ High-alert (LASA) and concentrated electrolyte medications require strict double-checking and distinct red/yellow labeling to prevent errors.
➡️ Cytostatic compounding necessitates a stringent aseptic protocol involving appropriate PPE and LAF utilization.
➡️ Emergency Trolleys are secured with coded locks, and their contents are managed using a color-coded expiry sticker system (Red <4 months, Yellow <6 months).
➡️ Prevention of Medication Error relies heavily on improving communication, utilizing digital systems like BCMA, and conducting proactive risk analysis via FMEA.

📸 Video summarized with SummaryTube.com on Dec 31, 2025, 02:51 UTC