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Exploration of therapeutic interventions that accompany the administration of p.r.n. (‘as required’) psychotropic medication within acute mental health settings: A retrospective study
Author(s) -
Curtis Janette,
Baker John A.,
Reid Amanda R.
Publication year - 2007
Publication title -
international journal of mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.911
H-Index - 54
eISSN - 1447-0349
pISSN - 1445-8330
DOI - 10.1111/j.1447-0349.2007.00487.x
Subject(s) - medicine , psychological intervention , retrospective cohort study , audit , mental health , administration (probate law) , intervention (counseling) , pro re nata , emergency medicine , psychiatry , management , political science , law , economics , bevacizumab , ranibizumab , chemotherapy
Within acute mental health settings, pro re nata (p.r.n.) ‘as required’ medication is a widely used adjunct to regular treatment plans, and is administered at the discretion of a registered nurse. However, there is concern that some orders may benefit staff more than patients by providing a ‘quick fix’ to compensate for inadequate therapeutic programmes. Previous authors assert that p.r.n. medication administration should not be the first line of action, but should be used when other less invasive interventions such as de‐escalation, talking, or separation from the group are unsuccessful. This project explored the occurrence of p.r.n. medication administration and the type of alternative therapeutic interventions that are documented as accompanying its administration. A retrospective 1‐month chart audit was undertaken for a cohort of inpatients in a 20‐bed mental health facility attached to a regional hospital in New South Wales, Australia. Forty‐seven patients (73.4%) received p.r.n. medication at least once, with a total of 309 doses of p.r.n. medication administered during this time. There were wide variations in the documented rationales, and for nearly three‐quarters (73%) of p.r.n. medication administrations, no other therapeutic intervention was documented as occurring prior to administration.