Assessment of Pharmacist Integrated Patient Progress Notes at Ibnu Sina Islamic Hospital Pekanbaru


Authors : Novtafia Endri; Hansen Nasif; Yelly Oktavia Sari

Volume/Issue : Volume 8 - 2023, Issue 1 - January

Google Scholar : https://bit.ly/3IIfn9N

Scribd : https://bit.ly/3DCmBfI

DOI : https://doi.org/10.5281/zenodo.7601377

Integrated Patient Progress Notes also known as the Catatan Perkembangan Pasien Terintegrasi (CPPT) is a documentation carried out by professional caregivers about the development of a patient's condition in an integrated form in the patient's medical record using the SOAP (Subjective, Objective, Assessment, Plan) method. Incomplete and unsuitable CPPT writing can affect the continuity of care and the quality of patient care, which will affect the patient's therapeutic outcomes. This study aims to assess the completeness and suitability of writing integrated patient progress notes by pharmacists at Ibnu Sina Islamic Hospital Pekanbaru. This study is an analytic descriptive study with prospective data collection using total sampling from patient medical records. The inclusion criteria in this study were CPPT written last by the pharmacist. Medical records that meet the inclusion criteria as research subjects are 32 CPPTs at Pharmacist 1 and 31 CPPTs at Pharmacist 2. From this study, the results of the analysis of the completeness of CPPT writing at Pharmacist 1 were that there were no CPPTs (0%) written in full of the 32 CPPTs analyzed, and the results of the analysis of the suitability of CPPT writing were 2 CPPTs (6.25%) written in suitable with the 32 CPPTs analyzed. The results of the analysis of the completeness of CPPT writing on Pharmacist 2 are that there is no CPPT (0%) written completely from the 31 CPPT analyzed, and the results of the analysis of the suitability of CPPT writing are as many as 3 CPPT (9.67%) written suitable from the 31 CPPT analyzed.

Keywords : Integrated Patient Progress Notes; Pharmacist; Medical Records; Writing.

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