PART I

PRELIMINARY
1.1 Background
The nurse is a person who has passed the education both inside and outside
the country in accordance with the laws and regulations (Minister of Health, 2010).
The nurse is a person who has the ability and authority nursing action based
on the knowledge they have acquired through nursing education (Health Act No. 23
of 1992)
The task of a nurse before giving the drug is to be checking the patient's
identity includes: boards identity in bed, identity bracelet or asked directly to
patients and families. If the patient can not respond verbally, non-verbal responses
can be used, for example, the patient nodded. If the patient is not able to identify
themselves as a result of mental disorder or consciousness, to look for other means
of identification such as check directly to her family. Drugs have a trade name and
a generic name. Every drug under the trade name must be checked before the
generic name of the drug is given by nurses. Before giving the medicine to the
patient, the label on the bottle or packaging must be checked three times. The first
time reading the demand for drugs and the bottle was taken from the medicine
cabinet, both the bottle label compared with drugs that are requested, the third time
returned to the medicine cabinet. If the label is unreadable, it should not be used
and the duties of a nurse is a need to revert to the pharmacy. Once the drug is given,
the duties of a nurse is to document, dose, method / s, when and by whom the drug
was administered. If the patient refuses to be given the drug, or the drug can not be
given for any reason, the nurse should record the reason and reported to a doctor for
further action.
Nurses are responsible for the administration of drugs - drugs are safe. Nurses
should be aware of all the components of the drug delivery orders and questioned
the order if it is incomplete or unclear, or the dose administered beyond the
recommended limit. Legally nurse responsible if they provide drugs prescribed and
the dosage is incorrect or the drug is contraindicated for the client's health status.
 Once the drug has been given, the nurse responsible for the effects of drugs that
supposedly was going to happen. Reference books drugs such as, Drugs List
Indonesia (DOI), the Physicians' Desk Reference (PDR), and human resources,
such as pharmacists, should be utilized nurse if you feel unclear about the reaction
of the expected therapeutic, contraindications, dosage, side effects that may occur,
or adverse reactions of the treatment (Kee and Hayes, 1996)

1.2 Objectives
a. In order for a nurse to know what the role should be owned in the provision.
b. So that nurses can respect the rights of patients in drug delivery.
c. In order for a nurse is not any longer in drug delivery.
d. In order for nurses to understand what needs to be noticed in drug delivery.
 CHAPTER II
LITERATURE REVIEW
2.1 Definition of Nurses
The nurse is a person who has passed the education both inside and outside
the country in accordance with the laws and regulations (Minister of Health, 2010)
Nursing is a form of health care professionals are an integral part of health
care based on nursing science and troubleshooting, in the form of bio-psycho-socio
spiritual Comprehensive intended for individuals, families, groups, and
communities are either healthy or sick, which includes the whole process human
life (national nursing Workshop, 1983)
The nurse is a person who has the ability and authority nursing action based
on the knowledge they have acquired through nursing education (Health Act No. 23
of 1992)
So the nurse is to give someone who has graduated nurse education and have
the ability and the authority to take action kerpawatan based on science that is
owned and provide health services holistic and professional to the individual
healthy or sick, nurses required to meet the needs of patients include bio-psycho-
social and spiritual.

2.2 Definition of Drugs

Drugs are objects or substances that can be used to treat the disease, freeing
symptoms, or changing the chemical processes in the body. Drug is a substance or
combination of ingredients that are intended to be used in establishing a diagnosis,
prevent, reduce, eliminate, cure disease or symptoms of disease, injury or
abnormality corporal and spiritual in humans or animals and to adorn or beautify
the body or parts of the human body including traditional medicine.

2.3 Role of Nurses in Drug Dispensing

Nurses must be skilled and precise when giving medication, not just giving a
pill to be taken (oral) or intravenous drug injection (parenteral), but also to observe
the client's response to administration of the drug. Knowledge about the benefits
and side effects of drugs is very important to have nurses. Nurses have a major role
in improving and maintaining the health of the client by encouraging clients to be
more proactive if need treatment. The nurse tried to assist clients in building a true
sense and clear about the treatment, consult any drugs been booked and participate
in decision keputusa responsible on treatment along with other health professionals.
Nurses in providing prescription drugs must also consider the given drug to be
precise, exact count on the administered dose as prescribed, and always use:
 12 correct principles, namely:
1.Benar Clients
Always be ascertained by examining the patient's identity by checking
the identification bracelet and asked to mention his own name. Client is
entitled to know the reasons drug Client is entitled to reject the use of a drug
Distinguishing two clients with the same name
2. Right Drugs
a. Clients can receive drugs that have diresepkaNn
b. Nurses are responsible for following the proper commands
c. Nurses should avoid the mistake of reading the drug label at least three
times:
1. When viewing a bottle or drugs
2. Before pouring / suck medicine
3. After pouring / sucking drug
d. Check whether the order is complete and valid treatment
e. Know the reasons why the client receives the drug
f. Providing drugs mark: drug name, an expiration date
3. Right Drug Dosage
a. The dose given client according to the client's condition.
b. The dose given within the recommended limits for individual drugs.
c. Nurses must be meticulous in accurately calculate the number of doses to
be provided, taking into account such things as the following: the
availability of drugs and dose of drugs prescribed / requested,
 consideration of weight loss clients (mg / kg / day), if in doubt dosage
drugs must be recalculated and checked by another nurse.
d. View the recommended limit for dose of a particular drug.
4. True Time Giving
a. Provision of drugs should be in accordance with a predetermined time
b. Daily drug dose given at certain times of day. For example, as twice a
day, three times a healthy, four times a day and six times a day so that the
plasma drug levels in the body can be considered.
c. Provision of drugs must comply with drug half life (t ½). Drugs that have
a long half-life is given once a day, and for drugs that have a short half
given several times a day at specified intervals. Drug administration is
also concerned given before or after meals or with food
d. Providing drug medications such as potassium and aspirin can irritate the
gastric mucosa together with the food.
e. Being a nurse's responsibility to check whether the client has been
scheduled for a diagnostic check, such as fasting blood test is
contraindicated drug test.
5. Correct the Giving
a. Noting the drug absorption process in the body should be appropriate and
adequate.
b. Taking into account the client's ability to swallow before giving the drugs
orally.
c. Using aseptic technique when giving the drug through parenteral route
d. Providing drug at a suitable place and stay with the client until the oral
medication has been swallowed. routes more often than absorption are:
1. . Oral (by mouth): liquids, suspensions, pills, caplets, or capsules.
2. Sublingual (under the tongue for absorption vein);
3. buccal (between the cheek and gum)
4. topical (applied to the skin);
5. inhalation (aerosol spray);
6. instillation (eyes, nose, ears, rectum or vagina)
 7. Parenteral: intradermal, subcutaneous, intramuscular, and
intravenous.
6. True Document.
Administration of drugs in accordance with standard procedures in the
hospital. And always record relevant information about drugs that have been
provided as well as the client's response to treatment.
7. True health education regarding medications client
Nurses have a responsibility to conduct health education to patients,
families and the wider community, especially with regard to medications like
the drug benefit in general, drug use is good and right, the reason drug
therapy and comprehensive health, expected results after pembeian drug, side
effects and adverse reactions of drugs, drug-drug interactions with food and
medicine, changes are required in carrying out daily activities during illness.
8. Right to refuse clients
Client is entitled to reject the administration of the medicine. Inform
the nurse must give consent in drug delivery.
9. True pengkajianiksa TTV (vital signs) prior to administration.
10. Correct evaluation
Perawata always see / monitor the employment effects of the drug after
administration.
11. True reactions to food
The drug may be as effective if given at the right time If the drugs
should be taken before meals (ante cimum or a.c) to obtain the necessary
level should be given one hour before a meal, for example tetracycline, and
preferably no medication to be taken after a meal, for example
indomethacin.
12. True reaction with other drugs
In the use of drugs such as chloramphenicol given with omeprazole
use in chronic diseases. Nurses have a responsibility in the arrival of drug
keada patients and the use of drugs by the patient so that the drug is
effective dala help solve the problem of the patient. In detail the role of
nurses in the management of drug rmah mental illness are:
1. Collecting data before treatment
In the implementation of this role nurses supported by
background knowledge of the biological and behavioral. Data needs to be
collected between lainriwayat disease history engobatan medical
diagnostics laboratory results which will be used types of drugs and
nurses need to know the other therapy programs for patients. This data
collection is used so that the nursing care provided is comprehensive and
is one unit.
2. To coordinate drug therapy modalities
Selection of the appropriate therapy according to the patient's
treatment program will provide better results.
3. Health Education
Patients at a psychiatric hospital is in dire need of health education
about drugs obtained because patients often do not want to take
medication that is considered to no avail. Examples on unsuspecting
clients that consider drugs as a poison. Besides family health education is
also needed because of the assumption if the patient has been re-home it
is no longer need to take medication when it causes the risk of cancer
recurrence and nursed back.
4. To monitor drug side effects
In addition to the expected effects, the nurse must also monitor
drug side effects and other reactions that are less well after taking the
medication.
Because the drug can cure or harming the patient, the
administration of drugs to be one of the most important duties of nurses.
Nurses are the last link in the process of drug delivery to the patient. The
nurse in charge that the drug was administered and to ensure that the drug
was completely drunk. If there are drugs given to patients, it should be an
integral part of the care plan. Nurses who know most about the needs and
 the patient's response to treatment. For example, patients who are
difficult to swallow, vomiting or may not be taking certain drugs (in
capsule form). Factors visual disturbances, hearing, intellectual or motor,
which may lead to difficult patients taking medication, should be
considered. The treatment plan should covers drug treatment plan,
depending on the outcome of the assessment, and working knowledge of
drug interactions, side effects, duration of employment, and the doctor
program.
 Principle Six Right Patients
1. Right clien
Before the drug is administered, the patient should be examined
identity (ID bracelet on the bed, identity bracelet) or asked directly to
patients or their families. If the patient can not respond verbally, non-verbal
responses can be used, for example, the patient nodded. If the patient is not
able to identify themselves as a result of mental disorder or consciousness,
to look for other means of identification such as check directly to her
family. Babies should always be identified from identity bracelet.
2. Right Drugs
Drugs have a trade name and a generic name. Every drug under the
brand name that we foreigners (we have just heard his name) should be
checked its generic name, if necessary, contact your pharmacist to ask for its
generic name or drug content. Before giving the medicine to the patient, the
label on the bottle or packaging must be checked three times. The first time
reading the demand for drugs and the bottle was taken from the medicine
cabinet, both the bottle label compared with drugs that are requested, the
third time returned to the medicine cabinet. If the label is unreadable, it
should not be used and must be returned to the pharmacy. If the patient
dubious medicine, nurses should check it again. When giving medication to
the nurse must remember what the drug was administered. It helps to
remember the name of the drug and its work.
3. Right dose
Before giving medication, the nurse must check the dosage. If in
doubt, the nurse should consult with a doctor who writes a prescription or
pharmacist before continuing to the patient. If the patient dose dubious
nurse must examine it again. There are some good drug ampoules and
tablets have different doses of each ampoule or tablet. For example
ondansetron 1 amp, the dose is how much? This is important !! for 1 amp
ondansetron 4 mg dose there, there are also 8 mg. No antibiotics 1 vial dose
of 1 g, there is also 1 vial of 500 mg. so you should still be careful and
meticulous!
4. Right How / These
Drugs can be administered via a different route. The factors that
determine the best route is determined by the administration of the general
state of the patient, the desired response speed, chemical and physical
properties of the drug, as well as the desired workplace. The drug can be
given orally, sublingual, parenteral, topical, rectal, inhalation.
1. Oral, are the provision of the most common and most widely used, due to
economical, most convenient and secure. Drugs can also be absorbed
through the oral cavity (sublingual or buccal) tablets such as ISDN.
2. Parenteral, this word comes from the Greek, the meaning beside, enteron
means intestines, so parenteral means outside of the intestine, or through
the gastrointestinal tract, ie through a vein (perset / perinfus).
3. Topically, the administration of drugs through the skin or mucous
membranes. Eg, ointments, lotions, creams, sprays, eye drops.
4. Rectal, the drug can be given via the rectal route in the form of an enema or
suppository that will melt at body temperature. Rectal administration
conducted to obtain local effects such as constipation (dulkolax supp),
hemorrhoids (anusol), an unconscious patient / seizures (stesolid supp).
Administration of drugs perektal have a faster effect than the
administration of drugs in oral form, but unfortunately not all drugs are
provided in the form of suppositories.
 5. Inhalation, namely the administration of drugs via the respiratory tract.
Airway epithelial to have a very broad absorption, thus useful for drug
delivery locally on channel, for example salbotamol (Ventolin),
Combivent, berotek for asthma, or in an emergency, for example oxygen
therapy.
5. Right Time
This is very important, especially for drug effectiveness depends to
achieve or maintain adequate blood levels. If the drug should be taken before
meals, to obtain the required levels, should be given one hour before a meal.
Remember the antibiotics should not be given with milk because milk can
bind most of the drug before it can be absorbed. There is medication to be
taken after meals to avoid excessive irritation to the stomach eg mefenamic
acid.
6.Right Documentation
After the drug was administered, must be documented, dose, route,
time and by whom the drug was administered. If the patient refuses to take the
medicine, or drugs that can not be taken, it should be noted
2.4 Dispensing Errors
Error drug delivery, in addition to giving the wrong drug, includes other
factors that change the drug therapy is planned, such as forgetting to give
medication, prescribe two as well as compensation, giving the right drug at the
wrong time, or giving the right drug at the wrong route , If an error occurs the
administration of drugs, the nurse concerned should immediately contact a doctor
or the head nurse or senior nurse as soon as the error was known. IEC Guideline
2.5 Nurse to Patient or Family
Compliance occurs when the rules of use and administration of prescribed
drugs in the hospital followed correctly. If this therapy will be continued after
discharge, it is important that patients understand and be able to continue therapy it
correctly without supervision. This is especially important for chronic diseases,
such as asthma, rheumatoid arthritis, hypertension, TB, diabetes mellitus, and
others.
 Drug therapy is effective and safe can only be achieved if patients know the
ins and outs of the treatment as well as their role. For that before patients go home,
the nurse needs to provide the IEC to patients and families about:
1. Name of the medicine.
2. The usefulness of the drug.
3. The amount of the drug for a single dose.
4. The total number of times to take medication.
5. When the drug must be taken (before or after meals, antibiotics not be taken with
milk)
6. For how many days the medicine should be taken.
7. Should it be until they run or stop after complaints disappeared.
8. These drug delivery.
9. Get to know if there are any side effects or drug allergy and how to cope
10. Do not operate complicated machinery or driving a motor vehicle on a certain
drug treatments for example sedatives, antihistamines.
11. How drug storage, keep the refrigerator or not
12. After the drug out whether or not the necessary controls

2.6. Medication Management

In discussing about drug containment procedures are divided into two,
namely the provision of obatlangsung to patients and the management or storage of
drugs in the room.
1. The provision of drugs to patients
a. Principles of drug peberian
In discussing the principles of drug peberian it is divided into 3 persiaan
peberian and evaluation.
1) Preparation Peratama nurses have to see what medicine will be given. Then
assess the drug (destination peberian how the side effects dosage and
others). Afterwards ent preparations related to the patient including
reviewing patient medication history, knowledge of the patient and the
condition before treatment.
 2) Giving
There are 6 stages that must be considered nurses in drug delivery
- Right medicine
- Correct dosage
- Right patient,
- Correct timing
- The correct mode of administration
- Correct documentation
3) Evaluation
Nurses are responsible for monitoring the patient's response terhada
treatment. For drugs that are often used in mental hospitals side effects
normally seen until 1 hour after administration.
b. Methods specific approach in drug delivery
Provision of medicines for patients with mental disorders require a
special approach in accordance with the case as in the case of patients
suspected suicide patients and patients with drug dependence.
1). The specific approach to patients suspected
In patients suspected not trusting of an action or a gift given to
him. Nurses must ensure that actions undertaken treatment to patients is
not harmful and beneficial to patients. Verbal and non-verbal, nurses
must be able to control his behavior so as not to cast doubt on the patient
because of the actions of the nurse's hesitation would arouse suspicion
patient.
Give dala drugs and packaging the same shape each reflected on
drugs that patients are not confused, ceas and suspicion. If there is a
change in dose first discuss keada einta patient before the patient to
drink. Assure drug really drunk and swallowed by asking the patient
opened his mouth and use the spatula to see aakah disebunyikan drugs. It
terutaa in patients who have a history of drug hides under the tongue and
throw it away. For patients who absolutely refuse to take medication
despite the establishment aka emberian approach made through injection
 drug in accordance with the instructor doctors by observing the legal
aspects and the patient's right to refuse treatment in an emergency.
2) The specific approach to patients who are potentially suicidal.
In patients with suicide problem that often arises is the refusal
of the patient to take the medication with the intent to impair the patient
himself. Nurses should be firm dala supervision of patients to take
medication for patients at this stage are in phase ambivalent between life
and death wishes.
Nurses use the opportunity memunyai treatment when the patient
wishes to live, so that doubts the patient to end his life is reduced because
patients feel cared for. Attention Nurses is an important stimulus for the
patient to increase the motivation of life. Dala this is the role of nurses in
delivering drugs among nursing integrated approach to enhance the self-
esteem of patients.
3) The specific approach in patients with drug dependence
In patients who are seen ketegantungan medication usually assume
that the drug is everything in solving the problem. So nurses need to
explain to patients about the benefits of the drug and the drug is not the
only way to resolve the problem. Drug treatment should be tailored to
other modalities of therapy such as explanation of the ways elewati loss
process.
c. Health Education
Morally responsible nurses provide health education to patients and
families. Health education should be provided include information on the
progress of disease patient, medication, how to care for patients. Health
education related to drug peberian that information about drug side effects
and how to take the medicine dosage time.
 CHAPTER III
CONCLUSIONS AND RECOMMENDATIONS

3.1 Conclusions
Administration of drugs into one of the duties of a nurse's most important.
Nurses are the last link in the process of drug delivery to the patient. Nurses are
responsible for the drug was administered and ensures that the correct medication.
Drugs given to patients, become an integral part of the care plan. Nurses who know
most about the needs and the patient's response to treatment. For example, patients
who are difficult to swallow, vomiting or can not take medication for some reason.
Factors visual disturbances, hearing, intellectual or motor, which may lead to
patients not taking the drug bias should also be considered. The action plan should
keperawatanan plan covers the drug administration, knowledge of the work and
drug interactions, side effects, duration of drug action and program of the doctor.
The task of a nurse before giving the drug is to be checking the patient's identity
includes: boards identity in bed, identity bracelet or asked directly to patients and
families. If the patient can not respond verbally, non-verbal responses can be used,
for example, the patient nodded. If the patient is not able to identify themselves as a
result of mental disorder or consciousness, to look for other means of identification
such as check directly to her family.
Drugs have a trade name and a generic name. Every drug under the trade
name must be checked before the generic name of the drug is given by nurses.
Before giving the medicine to the patient, the label on the bottle or packaging must
be checked three times. The first time reading the demand for drugs and the bottle
was taken from the medicine cabinet, both the bottle label compared with drugs that
are requested, the third time returned to the medicine cabinet. If the label is
unreadable, it should not be used and the duties of a nurse is a need to revert to the
pharmacy. Once the drug is given, the duties of a nurse is to document, dose,
method / s, when and by whom the drug was administered. If the patient refuses to
be given the drug, or the drug can not be given for any reason, the nurse should
record the reason and reported to a doctor for further action.
3.2 Advice
Nurses need to understand exactly what she needs to have a role in the
administration of drugs to patients, to avoid mistakes. And if there was an error in
the administration of drugs, the nurse concerned should immediately contact a
doctor or the head nurse or senior nurse as soon as the error was known, in order to
be overcome.