CONCEPT OF NEEDS

SAFE, COMFORTABLE AND PAINFUL

Dosen Pengampu
El Rahmayati, S.Kp., M.Kes
Yuniastini, S.KM., M.kes

ARRANGED BY :

NADINE FRIZANIA ARDINA (2314301042)

SITI NURFATIMAH (2314301005)

NURSING STUDY PROGRAM

POLTEKKES KEMENKES TANJUNG KARANG
ACADEMIC YEAR 2023/2024

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 FOREWORD

We praise the presence of Allah SWT for His grace and guidance, so that the paper on
Basic Nursing "The Concept of Safe, Comfortable and Painful Needs" can be prepared. This
teaching material is used as reference material for Basic Nursing courses for lecturers and
students of the D4 Nursing Poltekkes Tanjung Karang Study Program.

In preparing this teaching material, there were various obstacles and shortcomings,
but with the help of various parties, this paper could be completed. So on this occasion the
author would like to thank all parties who have supported in the preparation of this teaching
material. Considering the imperfection of this paper, we expect suggestions and constructive
criticism for the perfection of this paper. So, hopefully it will be useful for all of us. At then
end of my speech, thank you.

Bandar Lampung, January 15 2023

Author

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 TABLE OF CONTENT

COVER ..............................................................................................................................1
FOREWORD ....................................................................................................................2
TABLE OF CONTENT3

CHAPTER 1 INTRODUCTION......................................................................................4
A. Background .......................................................................................................4
B. Problem Identification ......................................................................................4
C. Objective ...........................................................................................................4
D. Benefit ...............................................................................................................4

CHAPTER 2 LITERATURE REVIEW .........................................................................5

A. Concept of Safety, Comfort and Pain Needs ....................................................5
B. Safety, Comfort and Pain Needs Assessment ...................................................9

CHAPTER 2 DISCUSSION ............................................................................................12

A. Diagnosis Of Needs For Safe Comfort And Pain (SDKI).................................12
B. Safe Comfort And Pain Needs Intervention (SIKI)...........................................13
C. Implementation Of Safe Comfortable And Painful...................................................19

CHAPTER 5 CLOSING ..................................................................................................20

A. Conclusion ........................................................................................................20
B. Suggestion .........................................................................................................20

BIBLIOGRAPHY .............................................................................................................21

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 CHAPTER 1
INTRODUCTION

A. BACKGROUND

The role of nurses in patient recovery is a very important role, because nurses will
always be beside the patient 24 hours a day. So, nurse competency is required in providing
health services to patients. The good or bad health services in a hospital are determined by the
good or bad services provided by the health team, including nurses. The scope, perspective of
nursing and the nursing process are basic knowledge that must be adhered to and used as
principles for nurses in applying their knowledge. How broad the boundaries are in each
science in the field of nursing must be clear so that nurses in carrying out their duties and
roles do not overlap with other health professions. The nursing process, both in application
and documentation, must also be carried out in accordance with established standards so that
nursing practice runs professionally.

In this paper, basic nursing science will be discussed, namely the concept of safety,
comfort and pain needs. After studying this Basic Nursing material, it is hoped that students
will be able to master the techniques, principles and procedures for implementing nursing
care/practice carried out independently or in groups and be able to provide care to
individuals, families and groups in health, illness and emergencies by paying attention to bio-
aspects. , psycho, social, cultural and spiritual which ensure client safety (patient safety),
according to basic care standards and based on existing nursing plans. Students' mastery of
Basic Nursing will be very useful in maximizing the nursing care process.

B. PROBLEM IDENTIFICATION
1) What is meant by safe and comfortable?
2) How do you assess safety and comfort needs ?
3) How to diagnose safely and comfortably (IDHS) ?
4) What are the safe and comfortable needs interventions (SIKI) ?
5) How is Nursing Implemented ?

C. OBJECTIVE
1) Mastering theoretical concepts of basic human needs
2) Able to provide nursing care to individuals, families and groups in health, illness and
emergencies by paying attention to bio, psycho, socio-cultural and spiritual aspects
that ensure client safety (patient safety), according to nursing care standards and
based on existing nursing plans

D. BENEFIT
1) This paper is able to provide knowledge and insight regarding the concepts of safety,
comfort and pain
2) It is hoped that this paper can be used as a learning reference

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 CHAPTER 2
LITERATURE REVIEW

A. CONCEPT OF SAFETY, COMFORT AND PAIN NEEDS

1) The concept of security needs

The need for safety or security is the need to protect oneself from physical danger.
Threats to a person's safety can be categorized as mechanical, chemical and
bacteriological threats. The need for safety is related to the physiological context and
interpersonal relationships. Security, often defined as a state of being free from
physical and psychological harm, is one of the basic human needs that must be met. A
safe health care and community environment is important for client survival. Comfort
is a central concept regarding nursing tips. The concept of comfort has the same
subjectivity as pain. Each individual has physiological, social, spiritual, psychological
and cultural characteristics that influence the way they interpret and feel pain.

a. Definition
Security is a state of being free, not only from physical and psychological injury
but also feeling safe and secure (Potter and Perry, 2005). The need for safety or
security is the need to protect oneself from physical danger in the context of
physiological and interpersonal relationships (Carpenito, Linda Sell, 2000).
Physiological security is related to something that threatens a person's body and
life. Something that threatens can be in the form of real things or just imagination,
such as disease, pain, anxiety, etc.

b. Classification of Security or Safety Needs

 Physical Safety
 Psychological Safety

c. Scope of Security or Safety Needs

The client's environment includes all physical and psychosocial factors that
influence or result in the client's life and survival.
 Physiological needs consist of the need for oxygen, fluids, nutrition,
temperature, elimination, shelter, rest and sex.
 Scopes that influence psychosocial needs are things that threaten a person's
self-concept. Such as things that threaten a person's self-image, self-ideal,
self-esteem, self-role and self-identity. Level of development and maturity,
culture, external and internal sources (eg effective individual coping and
community support or good socio-economic status), self-concept of success
and failure, stressors, age, illness and trauma.
 Environments that threaten security or safety can occur anywhere, whether at
home, hospitals and various things that can threaten such as microorganisms,
light, noise, injuries, procedural errors, medical equipment, etc.

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 d. Factors Affecting Security or Safety
 Age
 Level of Awareness
 Emotion
 Metabolic Status
 Sensory perception disorders
 Information/communication
 Use of antibiotics
 State of immunity
 The body's inability to produce white blood cells
 Nutritional status
 Knowledge level

e. How to improve security or safety for patients in hospitals

 Assess the patient's level of ability to protect themselves
 Maintain the safety of anxious patients
 Maintain the safety of the equipment used (gurney, wheelchair, bed)
 Provides a bedside barrier
 Place a bell that is easy to reach in the patient's room
 Floor cleanliness
 Pay attention to standard operating procedures (SOP) in providing nursing
care to patients

2) The concept of the need for comfort

a. Definition
Comfort Changes in comfort are a situation where an individual experiences an
unpleasant sensation and responds to a dangerous stimulus (Carpenito, Linda Jual,
2000). Kolcaba (1992, in Potter & Perry, 2005) states that comfort/sense of
comfort is a state of having basic needs fulfilled. human needs, namely the need
for peace (a satisfaction that improves daily performance), relief (the need has
been met), and transcendence (the state of something beyond problems and pain).
Comfort must be viewed holistically which includes four aspects, namely:
 Physical, related to bodily sensations
 Social, related to interpersonal, family and social relationships
 Psychospiritual, related to internal awareness within oneself which includes
self-esteem, sexuality, and the meaning of life)
 Environment, related to the background of human external experiences such
as light, sound, temperature, color and other natural elements.
Increasing the need for comfort means that the nurse has provided strength, hope,
entertainment, support, encouragement and assistance. In general, in its
application, fulfilling the need for comfort is the need for comfort, free from pain
and hypo/hyperthermia. This is caused by the condition of pain and
Hypo/hyperthermia is a condition that affects the patient's feelings of discomfort
as indicated by the appearance of symptoms and signs in the patient.

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 b. Factors Affecting Comfort
 Emotion
Anxiety, depression, and anger
 Mobilization status
Limited activity, paralysis, muscle weakness, and decreased consciousness
increase the risk of injury
 Sensory Perception Disorders
Affects adaptation to noxious stimuli such as smell and vision disorders
 State of Immunity
This disorder will cause the body's resistance to decrease so that it is
susceptible to disease
 Level of Awareness
In comatose patients, the response will be decreased to stimuli, paralysis,
disorientation, and lack of sleep
 Information or Communication
Communication disorders such as aphasia or not being able to read can cause
accidents
 Knowledge Level Disorders
Awareness that safety and security disturbances will occur can be predicted in
advance.
 Irrational Use of Antibiotics
Antibiotics can cause resistance and anaphylactic shock
 Nutritional status
Malnutrition can cause weakness and easily cause disease, and conversely it
can put you at risk for certain diseases
 Age
Developmental differences found between the pediatric and elderly age
groups influence reactions to pain
 Gender
In general, men and women do not differ significantly in their response to
pain and comfort level.
 Culture
Cultural beliefs and values influence how individuals deal with pain and the
level of comfort they have.

3) Pain Concept
a) Definition of Pain
Pain is an uncomfortable feeling that is very subjective and only the person who
experiences it can explain and evaluate this feeling (Long, 1996). In general, pain
can be defined as a feeling of discomfort, whether mild or severe (Priharjo, 1992).

b) Physiology of Pain
The occurrence of pain is closely related to receptors and the presence of
stimulation. The pain receptors in question are nociceptors, which are very free
nerve endings that have little or no myelin, which are spread across the skin and

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 mucosa, especially in the vicera, joints, artery walls, liver and gallbladder. Pain
receptors can respond due to stimulation or stimulation. This stimulation can be in
the form of chemical substances such as bradykinin, histamine, prostaglandins,
and various acids which are released when there is damage to tissue due to lack of
oxygenation. Other stimulation can be thermal, electrical or mechanical.

c) Pain Experience
A person's experience of pain is influenced by several things, namely:
 The Meaning of Pain for the Individual
Pain has a different meaning for each person, also for the same person at
different times. Generally, humans view pain as a negative experience,
although pain also has positive aspects. Some meanings of pain include being
dangerous or damaging, indicating a complication (e.g. infection), requiring
healing, causing disability, being a punishment for sin, being something that
must be tolerated. Factors that influence the meaning of pain for individuals
include age, gender, socio-cultural background, environment, current and past
pain experiences.

 Pain Perception
Basically, pain is a form of reflex to avoid stimulation from outside the body,
or to protect the body from all forms of danger. However, if the pain is too
severe or lasts a long time it can have bad consequences for the body, and this
will cause the sufferer to become restless and hopeless. If the pain tends to be
unbearable, the sufferer can commit suicide. (Setyanegara, 1978).

 Tolerance of Pain
Related to the intensity of pain that makes a person able to endure pain before
reaching help. A high level of tolerance means that the individual is able to
endure severe pain before he seeks help. Although each person has a
relatively stable pain tolerance pattern, tolerance levels vary depending on the
situation at hand. Tolerance to pain was not influenced by age, gender,
fatigue, or slight changes in attitude.

 Reaction to Pain
Each person reacts differently to pain. There are people who respond with
feelings of fear, anxiety and anxiety, there are also those who respond with an
optimistic and tolerant attitude.

d) Pain Classification
 Acute Pain
Pain that occurs after an acute injury, illness or surgical intervention and has a
rapid onset, varies in intensity (mild to severe) and lasts a short time (less than
six months and disappears with or without treatment after recovery of the
damaged area.

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  Chronic Pain
Constant or intermittent pain that persists over a period of time. Pain caused
by malignant causes such as uncontrolled or non-malignant cancer. Chronic
pain lasts a long time (more than six months) and will continue even if the
patient is given treatment or the disease appears to be cured. The
characteristics of chronic pain are that the area of pain is not easily identified,
the intensity of the pain is difficult to reduce, the pain usually increases, the
nature of the pain is less clear, and there is little chance of healing or
disappearing. Non-malignant chronic pain is usually associated with pain due
to tissue damage that is non-progressive or has been experience healing.

e) Measuring Pain Scale

Pain intensity (pain scale) is a description of how severe the pain an individual
feels, measuring pain intensity is very subjective and individual and it is possible
that pain of the same intensity is felt very differently by two different people.
(Tamsuri, 2007).

0 : No pain
1-3: Mild pain
4-6: Moderate pain
7-9: Very painful, but still able to do activities
10: Very painful, and cannot be controlled

B. SAFETY AND COMFORT NEEDS ASSESSMENT

In general, the assessment begins by collecting data regarding the patient's biodata,
main complaint, history of current illness, history of past illnesses, family health history,
work history and habits, psychosocial history, and physical examination (Andarmoyo, S.
2016).

1) Patient identity and biodata (age, gender, occupation, education) includes assessment
of name, age, gender, religion, education, occupation, ethnicity or nationality, date of
hospital admission, date of assessment, RM number, medical diagnosis, and client
address .

2) The identity of the person in charge includes reviewing name, age, education,
employment, relationship with clients, and address.

3) The main complaint is the client's complaints when entering the hospital, apart from
that it reveals the reason why the patient needs help so that the client is taken to the
hospital and tells about when the patient experienced this disturbance.

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4) The current medical history reveals the most frequent complaints experienced by
patients during assessment using the PQRST method. This method includes the
following:
 P (Provocative/Palliative), namely causing complaints to occur, what things
make things easier or worse or the patient's complaint 9 is developed from the
main complaint.
 Q (Quality/Quantity), namely how severe the complaint feels, how it feels,
how often it occurs.
 R (Regional/Radiation), namely the location where the complaint was felt or
found, whether there was also spread to other areas, areas or areas of
distribution.
 S (Severity of scale), the intensity of complaints is expressed as mild,
moderate and severe complaints.
 T (Time), namely when the complaint began to be discovered or felt, how
often it was felt or occurred, was it gradual, was the complaint repeated, if it
repeated over a period of time, how long was this to determine the time and
duration.

5) Previous medical history. To obtain a profile of previous illnesses, injuries or

operations experienced by clients. For example, symptoms, course, termination,
recurrence of complications, incidence of illness in other family members or the
community, emotional response to previous hospitalization, and the occurrence and
nature of injury.
 Allergy history examines unusual reactions to foods, drugs, animals, plants, or
household products such as medicines (includes name, dosage, schedule, duration,
and reason for administration)
 Habits are behavioral patterns such as nail biting, thumb sucking, pika, rituals,
such as “security blankets”, unusual movements (head banging, climbing), and
peaceful places and daily activities such as sleeping and waking times, nap
duration or night, toilet training age, defecation and urination patterns, type of
training.

6) Physical examination Physical examination is very important in data collection. There

are four ways of physical examination, namely inspection, palpation, percussion and
auscultation. To get information about potential health problems. The physical
examination should be carried out systematically from head to toe or head to toe.
 Inspection, collecting data through looking, observing, hearing, or smelling. For
example, the condition of the wound can be seen by redness, granulation, pus, dry
or moist wound, length and depth of the wound. Patients with asthma can hear
wheezing sounds even without using a stethoscope. Nurses can also identify the
smell of gangrene, the smell of ketones in the breath of patients with ketoacidasis.
There is pallor, cyanosis, skin color, the patient has difficulty breathing, nostril
breathing, atrophy of body parts, and other abnormalities that can be seen using
inspection examination techniques.

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  Auscultation, physical examination using a hearing instrument such as a
stethoscope. For example, auscultation of heart sounds can identify the presence
of heart sounds, I, II, III or IV, heart murmurs, murmurs, gallops. Examination of
bowel and lung sounds can also be identified by auscultation, for example rales,
bronchial, vesicular and rhonchi sounds.
 Palpation, this technique can be used to collect data, for example, to determine the
presence of tenderness, tenderness, sensation, body temperature, tumor mass,
edema and tenderness.
 Percussion, namely examination by tapping the part of the body being examined.
This technique can identify tenderness, knocking pain, determine the presence of a
mass or infiltrate, determine the presence of changes in organ sounds, such as
tympanic sounds, dullness, flatness.

7) Supporting or diagnostic examinations Data on diagnostic test results are really

needed because they are more objective and more accurate. For example, to determine
the nutritional status of anemia patients, it can be determined by examining
hemoglobin and albumin. Indication of infection by examining leukocytes. Other
diagnostic tests include radiology, urine and stool examinations, ultrasound, MRI, etc.

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 CHAPTER 3
DISCUSSION

A. DIAGNOSIS OF NEEDS FOR SAFE COMFORT AND PAIN (SDKI)

Nursing diagnosis is a clinical assessment of the client's response to the health

problems or life processes they are experiencing, both actual and potential. Nursing diagnosis
aims to identify individual client, family and community responses to health-related
situations (IDHS: 2016).

1) Disturbance of Comfort

Definition
Feelings of lack of joy, relief and perfection in the physical, psychospiritual,
environmental and social dimensions.

Reason
 Disease symptoms
 Lack of situational/environmental control
 Inadequate resources (ex: financial, social and knowledge support)
 Lack of privacy
 Environmental stimulus interference
 Side effects of therapy (eg: medication, radiation, chemotherapy)
 Pregnancy adaptation disorders

Major Symptoms and Signs

 Subjective : Complaining about being uncomfortable
 Objective : Nervous

Minor Symptoms and Signs

 Subjective : Complaining of difficulty sleeping, unable to relax, complaining of
being cold or hot, feeling itchy, complaining of nausea, complaining of being
tired.

 Objective : shows symptoms of distress, appears to be moaning or crying,

elimination patterns change, body posture changes, irritability.

2) Pain Disorders

Definition
Pain is a nursing diagnosis defined as a sensory or emotional experience related to
actual or functional tissue damage, with sudden or slow onset and mild to severe
intensity that lasts less than 3 months.

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 Signs and symptoms
 Subjective : Complaining of pain
 Objective : Looks grimacing, protective ( alert, avoidant position).
pain), restlessness, increased pulse rate, difficulty sleeping

Reason
 Physiological agents of injury (inflammation, ischemia, neoplasm)
 Chemical injurious agents (burns, chemical irritants)
 Physical injurious agents ( abscesses, amputations, burns, cuts, heavy lifting,
surgical procedures, trauma, excessive physical exercise).

B. SAFE COMFORT AND PAIN NEEDS INTERVENTION (SIKI)

The planning stage provides an opportunity for nurses, patients, families and those
closest to the patient to formulate a nursing action plan to overcome the problems
experienced by the patient. This planning stage has several important goals, including as a
means of communication between nurses and other health teams, improving continuity of
nursing care for patients, and documenting the process and criteria for the results of nursing
care to be achieved. The most important element in this planning stage is to prioritize the
sequence of nursing diagnoses, formulate goals, formulate evaluation criteria, and formulate
nursing interventions (Asmadi, 2009).

1) Comfort Intervention

In the Indonesian Nursing Intervention Standards (SIKI), the main interventions for
diagnosing comfort disorders are:

 Pain management

Pain management interventions in the Indonesian Nursing Intervention Standards

(SIKI) are coded (I.08238). Pain management is an intervention carried out by
nurses to identify and manage sensory or emotional experiences related to tissue
or functional damage with sudden or slow onset and mild to severe and constant
intensity. Actions taken in pain management interventions based on SIKI
include:

Observation
 Location, characteristics, duration, frequency, quality, intensity of pain
 Location of pain scale
 Identify non-verbal pain responses

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  Identify factors that aggravate and relieve pain
 Identify knowledge and beliefs about pain
 Identify cultural influences on pain responses
 Population influence of pain on quality of life
 Monitor the success of complementary therapies that have been given
 Monitor for side effects from analgesic use

Therapy
 Provide non-pharmacological techniques to reduce pain (eg acupressure ,
music therapy, biofeedback, massage therapy, aromatherapy, guided
imagination techniques, warm/cold compresses, play therapy)
 Control environments that aggravate pain (eg: room temperature, lighting,
distractions)
 Facilitate rest and sleep
 Pay attention to the type and source of pain in selecting pain relief strategies

Education
 Explain the causes, periods and triggers of pain
 Explain pain relief strategies
 Encourage self-monitoring of pain
 Encourage appropriate use of analgesics
 Teach pharmacological techniques to reduce pain

Collaboration
 Collaborative administration of analgesics, if necessary

 P position setting

Positioning interventions in the Indonesian Nursing Intervention Standards

(SIKI) are coded (I.01019). Positioning is an intervention carried out by nurses to
position body parts to improve physiological and/or psychological health.
Actions taken in positioning interventions based on SIKI include:

Observation

 Monitor oxygenation status before and after changing positions

 Monitor the traction device so that it is always correct

Therapy

 Place on an appropriate therapeutic mattress/bed

 Place in therapeutic position

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 Place frequently used objects within reach

 Place a bell or call light within reach

 Provide a firm/solid mattress

 Set a preferred sleeping position, if not contraindicated

 Adjust the position to reduce tightness (ex: semi-fowler)

 Set a position that improves drainage

 Position it in proper body alignment

 Immobilize and support the injured body part appropriately

 Elevate the affected body part appropriately

 Elevate the limb 20° or more above heart level

 Elevate the head of the bed

 Give the right pillow to the neck

 Provide support to the area of edema (eg: pillow under the arm or scrotum)

 Position to facilitate ventilation/perfusion (eg: prone/good lung down)

 Motivation to do active ROM or passive ROM

 Motivation is involved in changing positions, as needed

 Place in a position that may increase pain

 Avoid placing the amputation stump in a flexed position

 Avoid positions that cause tension on the wound

 Minimize shooting and pulling when changing positions

 Change position every 2 hours

 Change position with the log roll technique

 Maintains position and traction integrity

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 Education
 Inform when a position change will be made
 Teach how to use good posture and good body mechanics during position
changes

Collaboration

 Collaborative administration of premedication before changing positions, if

necessary

 Relaxation Therapy

Relaxation therapy interventions in the Indonesian Nursing Intervention

Standards (SIKI) are coded (I.09326). Relaxation therapy is an intervention
carried out by nurses to use stretching techniques to reduce signs and symptoms
of discomfort such as pain, muscle tension, or anxiety. Actions taken in
relaxation therapy interventions based on SIKI include:

Observation

 Identify decreased energy levels, concentration, or other symptoms that

interfere with cognitive abilities

 Documentation of relaxation techniques that have been used effectively

 Identify willingness, ability, and previous use of the Technique

 Check muscle tension, pulse rate, blood pressure, and temperature before
and after exercise

 Monitor response to relaxation therapy

Therapy

 Create a calm, uninterrupted environment with lighting and a comfortable

room temperature, if possible

 Provide written information about preparation and procedures for relaxation

techniques

 Wear loose clothing

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  Use a soft tone of voice with a slow, rhythmic cadence
 Use relaxation as a supportive strategy with analgesics or other medical
measures, as appropriate

Education
 Explains the purpose, benefits, limitations and types of relaxation available
(ex: music, compression, deep breathing, progressive muscle relaxation)

 explains in detail the selected relaxation intervention

 Suggest taking a comfortable position

 Encourage to relax and feel the sensation of relaxation

 Encourage frequent return or practice of the selected technique

 Demonstrate and practice relaxation techniques (ex: deep breathing,

stretching, or guided imagery)

2) Pain Intervention
When formulating what intervention to provide to a patient, the nurse must ensure
that the intervention addresses the cause. However, if the cause cannot be directly
addressed, the nurse must ensure that the intervention chosen can overcome the
signs/symptoms. In addition, nurses must also ensure that interventions can measure
nursing outcomes. In the Indonesian Nursing Intervention Standards (SIKI), the
main interventions for diagnosing acute pain are:
 Pain Management
Pain management interventions in the Indonesian Nursing Intervention Standards
(SIKI) are coded (I.08238). Pain management is an intervention carried out by
nurses to identify and manage sensory or emotional experiences related to tissue
or functional damage with sudden or slow onset and mild to severe and constant
intensity. Actions taken in pain management interventions based on SIKI include:

Observation
 Identify location, characteristics, duration, frequency, quality, intensity of
pain
 Identify the pain scale
 Identification of non-verbal pain responses
 Identify factors that aggravate and relieve pain
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  Identify knowledge and beliefs about pain
 Identify cultural influences on pain responses
 Identify the influence of pain on quality of life
 Monitor the success of complementary therapies that have been given
 Monitor for side effects from analgesic use

Therapeutic
 Provide non-pharmacological techniques to reduce pain (eg: TENS, hypnosis,
acupressure, music therapy, biofeedback, massage therapy, aromatherapy,
guided imagination techniques, warm/cold compresses, play therapy)
 Control environments that aggravate pain (eg: room temperature, lighting,
noise)
 Facilitate rest and sleep
 Consider the type and source of pain in selecting pain relief strategies

Education
 Explain the cause, period, and triggers of pain
 Explain pain relief strategies
 Encourage self-monitoring of pain
 Encourage appropriate use of analgesics
 Teach pharmacological techniques to reduce pain

Collaboration

 Collaborative administration of analgesics, if necessary

 Giving Analgesics

The analgesic administration intervention in the Indonesian Nursing Intervention

Standards (SIKI) is coded (I.08243). Analgesic administration is an intervention
carried out by nurses to prepare and administer pharmacological agents to reduce
or eliminate pain. Actions taken in analgesic interventions based on SIKI include:

Observation
 Identify pain characteristics (trigger, reliever, quality, location, intensity,
frequency, duration)
 Identification History of drug allergies
 Identify the appropriateness of the type of analgesic (narcotic, non-narcotic, or
NSAID) to the severity of the pain
 Monitor vital signs before and after administering analgesics

18
  Monitor analgesic effectiveness

Therapeutic
 Discuss the preferred type of analgesic to achieve optimal analgesia, if
necessary
 Consider use of a continuous infusion, or bolus of opioids to maintain serum
levels
 Set analgesic effectiveness targets to optimize patient response
 Document response to analgesic effects and adverse effects

Education
 Explain the therapeutic effects and side effects of medications

Collaboration
 Collaboration in administering doses and types of analgesics, according to
indications

C. IMPLEMENTATION OF SAFE COMFORTABLE AND PAINFUL

Nursing implementation is the realization of an action plan to achieve

predetermined goals. Activities in implementation also include continuous data collection,
observing client responses during the implementation of the action and after the action
(Budiono & Sumirah, 2015). The implementation of nursing on pain problems is by
reducing factors that can increase pain, modifying pain stimuli using non-pharmacological
techniques (relaxation techniques, feedback, guided imagination, distraction techniques,
hypnosis, acupuncture) and pharmacological techniques by administering analgesic drugs
to block stimulus transmission from occurring. changes in perception of pain (Hidayat &
Musrifatul, 2014)

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 CHAPTER 4
CLOSING

A. CONCLUSION
A sense of security is a condition of being free from physical and psychological
injury. Comfort/sense of comfort is a state where basic human needs have been fulfilled,
namely the need for peace (a satisfaction that improves daily performance), relief (a need has
been met), and transcendence (a state of something beyond problems and pain). Comfort
must be viewed holistically which includes four aspects, namely: physical, social,
psychospiritual and environmental.

Furthermore, pain is an unpleasant sensory and emotional experience resulting from

subjective tissue damage. Pain arises due to the response of nerves that receive pain both
from inside and outside the body and then carry the sensation to the brain. Pain is a condition
that is more than just a single sensation caused by a particular stimulus. Pain can be classified
into acute pain and chronic pain. This pain management uses a multidisciplinary approach
which includes pharmacological approaches (including pain modifiers), non-pharmacological
approaches such as relaxation, distraction techniques, giving warm/cold compresses, massage
or hypotension, etc.

B. SUGGESTION

The results of this paper can be input and reference for students to learn about the concepts of
safety, comfort and pain needs.

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 BIBLIOGRAPHY

Asmadi. (2008). Basic Concepts of Nursing. Jakarta: EGC

Mubarak and Chayatin. (2011). Textbook of Basic Human Needs. Jakarta: EGC.

PPNI. (2017). Indonesian Nursing Diagnosis Standards: Definitions and Diagnostic

Indicators, 1st Edition Print III (Revised). Jakarta: PPNI .

PPNI. (2019). Indonesian Nursing Outcome Standards: Definition and Criteria for
Nursing Outcomes, Edition 1 Print II. Jakarta: PPNI .

PPNI. (2018). Indonesian Nursing Intervention Standards: Nursing Definitions and Actions,
Edition 1 Print II. Jakarta: PPNI .

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