Incompatibility in the administration of intravenous parenteral preparations in the intensive care unit (ICU) in one of the hospitals in Indonesia
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Apr 23, 2025
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Abstract
The prescribing and administration of intravenous injection drug therapy to patients in hospitals is increasing to achieve immediate pharmacological effects but can have a high risk of incompatibility. Therefore, it is necessary to check for intravenous injection incompatibility before administering it. Identify incompatible pairs of intravenous injectable drugs in intensive care (ICU) rooms of hospitals in Indonesia. Survey of the incompatibility of Electronic Prescribing (E-Prescribing) of intravenous injection drugs in the ICU room retrospectively using the Lexicomp application. From the results of retrospective identification of electronic prescriptions for the period from January 2022 to May 2023, data was obtained on the number of patients of 165 people, consisting of 91 people receiving compatible prescriptions and 74 patients receiving incompatible prescriptions. The number of intravenous injection drugs used was 60 types with the number of incompatible drug pairs 102 and the frequency of incompatible drugs 303. From the results of the evaluation of the incompatibility mechanism of intravenous drug injection pairs, it was found that 68 pairs of acid-base reactions, 18 pairs of mixed solvent dilution, 8 pairs of gas formation, 6 pairs of broken emulsions and 2 pairs of ionic reactions. Identification of patients' electronic prescriptions is still found to be incompatible with drug pairs, therefore it is necessary to take precautions.
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How to Cite
Tobing, J. L., Bangun, H. and Arianto, A. (2025) “Incompatibility in the administration of intravenous parenteral preparations in the intensive care unit (ICU) in one of the hospitals in Indonesia”, Science Midwifery, 13(1), pp. 255-270. doi: 10.35335/midwifery.v13i1.1824.
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Rahmawati, R., Rahmawati, F., & Sulaiman, S. A. S. (2018). Problem Kompatibilitas dan Stabilitas Pencampuran Sediaan Intravena Pada Pasien Anak di RSUP Dr. Sardjito. Jurnal Farmasi (Journal of Pharmacy), 7(1), 19–23.
Reid-Searl, K., Moxham, L., Walker, S., & Happell, B. (2009). Internal conflict: Undergraduate nursing students’ response to inadequate supervision during the administration of medication. Collegian, 16(2), 71–77.
Setiawati, M. C. N., & Munisih, S. (2023). Incompatibility Profile of Intravenous Drug Preparations for Intensive Care Unit Patients at’X’Hospital Semarang for the period January-June 2022. Jurnal Penelitian Farmasi Indonesia, 12(2), 60–64.
Setyani, W., & Putri, D. C. A. (2020). Resep dan Peracikan Obat. Sanata Dharma University Press.
Syahbarni, S., Setiawati, M. C. N., & Ningrum, E. P. (2021). Gambaran Kompatibilitas Sediaan Obat Intravena Dengan Sediaan Lain Pada Pasien Di ICU. Media Kesehatan Politeknik Kesehatan Makassar, 16(1), 83–89.
Taxis, K., & Barber, N. (2004). Incidence and severity of intravenous drug errors in a German hospital. European Journal of Clinical Pharmacology, 59, 815–817.
Ulfa, A. M. (n.d.). BAB 3 BAHAN TAMBAHAN DALAM SEDIAAN CAIR. BAHAN TAMBAHAN SEDIAAN FARMASI, 21.
Vijayakumar, A., Sharon, E. V, Teena, J., Nobil, S., & Nazeer, I. (2014). A clinical study on drug-related problems associated with intravenous drug administration. Journal of Basic and Clinical Pharmacy, 5(2), 49.
WHO. (2017). Global Patient safety challenge. medication without harm. Geneva: World Health Organization.
YULIANI, I. K. A. A. N. I. (2021). PENGARUH VARIASI KONSENTRASI PROPILENGLIKOL DAN PVA TERHADAP STABILITAS MASKER PEEL OFF EKSTRAK KULIT JENGKOL. Stikes Karya Putra Bangsa Tulungagung.
Akbar, F. (2020). Perbandingan Pengaruh Pemberian Terapi Kombinasi (Anestesi Lokal Dan Analgesik Intravena) Dengan Monoterapi (Analgesik Intravena) Terhadap Tingkat Nyeri Pasca Operasi Sectio Caeasaria Di Rs Siti Khodijah Sepanjang. Universitas Muhammadiyah Surabaya.
Alvarez-Nunez, F. A., & Yalkowsky, S. H. (1999). Buffer capacity and precipitation control of pH solubilized phenytoin formulations. International Journal of Pharmaceutics, 185(1), 45–49.
Anderson, C., Boehme, S., Ouellette, J., Stidham, C., & MacKay, M. (2014). Physical and chemical compatibility of injectable acetaminophen during simulated y-site administration. Hospital Pharmacy, 49(1), 42–47.
Bernaerts, K., Evers, G., & Sermeus, W. (2000). Frequency of intravenous medication administration to hospitalised patients: secondary data-analysis of the Belgian Nursing Minimum Data Set. International Journal of Nursing Studies, 37(2), 101–110.
D’Huart, E., Vigneron, J., & Demoré, B. (2019). Physical compatibility of intravenous drugs commonly used in intensive care units: an observational study and physical compatibility laboratory tests on anti-infective drugs. Pharmaceutical Technology in Hospital Pharmacy, 4(1), 29–40.
Fahimi, F., Ariapanah, P., Faizi, M., Shafaghi, B., Namdar, R., & Ardakani, M. T. (2008). Errors in preparation and administration of intravenous medications in the intensive care unit of a teaching hospital: an observational study. Australian Critical Care, 21(2), 110–116.
Gin, A., & Walker, S. (2009). Notice to Hospitals Regarding Ceftriaxone–Calcium Incompatibility: What’sa Clinician to Do? The Canadian Journal of Hospital Pharmacy, 62(2), 157.
Hanifah, S. (2015). IDENTIFIKASI pH OBAT-OBAT YANG DIGUNAKAN DI PEDIATRIC INTENSIVE CARE UNIT (PICU) UNTUK PENCEGAHAN INKOMPATIBILITAS INTRAVENA. Jurnal Ilmiah Farmasi, 11(2), 55–64.
Hanifah, S. (2020). Stabilitas dan Kompatibilitas Injeksi Propofol Sebagai Anestesi Umum di Rumah Sakit: Tinjauan Sistematis.
Kanji, S., Goddard, R., Donnely, R., McIntyre, L., Turgeon, A., & Coons, P. (2010). Physical compatibility of drug infusions used in Canadian Intensive Care Units: a program of research. Crit Care Med, 38(9), 1890–1898.
Maharani, L., Astuti, A. W., & Achmad, A. (2014). Kompatibilitas pencampuran sediaan parenteral di bangsal bedah saraf RSUD Prof. Dr. Margono Soekarjo. Jurnal Farmasi Klinik Indonesia, 3(1), 1–9.
Mendel, Y., Kaisermann, J., & Pawlowski, M. (n.d.). Teknik Biologi Molekuler II. Cambridge Stanford Books.
Mosisa, B., Negeri, B., Bayisa, G., Sado, E., Fekadu, G., Gebre, M., Gamachu, B., & Sudhakar, S. (2020). Assessment of Intravenous Drugs Admixtures Incompatibilities at Nekemte Referral Hospital, West Ethiopia. American Journal of Health Research, 8(5), 84–88.
MOUDYTA, K. (2021). FORMULASI MASKER GEL PEEL-OFF EKSTRAK ETANOL DAUN PANDAN WANGI (Pandanus amaryllifolius Roxb) SEBAGAI ANTIOKSIDAN. Universitas Perintis Indonesia.
Nurseta, T., Samsu, N., Perdhana, R., Palapa, H., Anggraeni, F. R., Wicaksono, B. A., Nugraha, N., & Gandhari, A. A. S. A. A. (2022). Kemoterapi Pada Kanker Ginekologi. Universitas Brawijaya Press.
Okuyama, A., Wagner, C., & Bijnen, B. (2014). Speaking up for patient safety by hospital-based health care professionals: a literature review. BMC Health Services Research, 14, 1–8.
Rahmawati, R., Rahmawati, F., & Sulaiman, S. A. S. (2018). Problem Kompatibilitas dan Stabilitas Pencampuran Sediaan Intravena Pada Pasien Anak di RSUP Dr. Sardjito. Jurnal Farmasi (Journal of Pharmacy), 7(1), 19–23.
Reid-Searl, K., Moxham, L., Walker, S., & Happell, B. (2009). Internal conflict: Undergraduate nursing students’ response to inadequate supervision during the administration of medication. Collegian, 16(2), 71–77.
Setiawati, M. C. N., & Munisih, S. (2023). Incompatibility Profile of Intravenous Drug Preparations for Intensive Care Unit Patients at’X’Hospital Semarang for the period January-June 2022. Jurnal Penelitian Farmasi Indonesia, 12(2), 60–64.
Setyani, W., & Putri, D. C. A. (2020). Resep dan Peracikan Obat. Sanata Dharma University Press.
Syahbarni, S., Setiawati, M. C. N., & Ningrum, E. P. (2021). Gambaran Kompatibilitas Sediaan Obat Intravena Dengan Sediaan Lain Pada Pasien Di ICU. Media Kesehatan Politeknik Kesehatan Makassar, 16(1), 83–89.
Taxis, K., & Barber, N. (2004). Incidence and severity of intravenous drug errors in a German hospital. European Journal of Clinical Pharmacology, 59, 815–817.
Ulfa, A. M. (n.d.). BAB 3 BAHAN TAMBAHAN DALAM SEDIAAN CAIR. BAHAN TAMBAHAN SEDIAAN FARMASI, 21.
Vijayakumar, A., Sharon, E. V, Teena, J., Nobil, S., & Nazeer, I. (2014). A clinical study on drug-related problems associated with intravenous drug administration. Journal of Basic and Clinical Pharmacy, 5(2), 49.
WHO. (2017). Global Patient safety challenge. medication without harm. Geneva: World Health Organization.
YULIANI, I. K. A. A. N. I. (2021). PENGARUH VARIASI KONSENTRASI PROPILENGLIKOL DAN PVA TERHADAP STABILITAS MASKER PEEL OFF EKSTRAK KULIT JENGKOL. Stikes Karya Putra Bangsa Tulungagung.