Effect of ethnic differences on the use of prn (as required) medication on an inner London medium secure unit

Hales, Heidi; Gudjónsson, Gisli H.

doi:10.1080/14789940410001702049

Cited by 14 publications

(14 citation statements)

References 14 publications

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“…Nevertheless, the 65% rate is slightly lower than the 70-80% reported in other in-patient populations (Hales & Gudjonsson, 2004;Baker et al 2008). The overall prevalence rate for PRN administrations was 65% but the rate of administration varied greatly across the health boards.…”

Section: Discussioncontrasting

confidence: 54%

The administration of psychotropic PRN medication in Scottish psychiatric intensive care units

Akram

Slevin

Davies

2014

J. Psychiatr. Intensive Care

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Information concerning the administration of psychotropic PRN medication in Scottish PICUs is scarce. The medical notes and prescription charts of all patients (n = 75) admitted during the study period were consulted to determine the frequency and nature of PRN practice. 65% of patients (n = 49) were administered up to 11 drugs comprising of antipsychotics (n = 8), benzodiazepines (n = 2) and zopiclone. The most frequently administered PRN medicines were lorazepam, haloperidol and zuclopenthixol. The mean dose administered for oral and intramuscular (IM) forms of both lorazepam and haloperidol were very similar. The mean number of PRN administrations per patient per day was 0.4. 40% of psychotropic PRN administrations were initiated by the nurse with the majority of doses administered at bedtime. Ten patients received an IM injection. Four patients were restrained during these administrations. Documentation pertaining to the rationale for IM administrations and of pre and post rapid tranquillisation physical health monitoring was lacking. This study highlights variation in practice between units, inadequate monitoring and documentation, a possible lack of understanding by prescribers of the differences in bioavailability between oral and injectable forms of medication and relatively limited use of newer drugs

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Section: Discussioncontrasting

confidence: 54%

The administration of psychotropic PRN medication in Scottish psychiatric intensive care units

Akram

Slevin

Davies

2014

J. Psychiatr. Intensive Care

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“…The prevention and containment of violence was the commonest indication for PRN administration but the numbers of patients involved was small and so it is difficult to come to firm conclusions. Another small retrospective study (42 patients) of PRN administration to forensic patients was carried out in a London medium secure unit by Hales and Gudjonsson (2004).…”

Section: Introductionmentioning

confidence: 99%

A study of the use of sedative PRN medication in patients at a secure hospital

Haw

Wolstencroft

2014

The Journal of Forensic Psychiatry & Psychology

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We have investigated the use of 'as required' (PRN), sedative psychotropic medication in 242 forensic rehabilitation patients at a UK secure psychiatric hospital. In total, 176 (73%) patients were prescribed PRN medication and 90 (37%) received a total of 542 doses in the preceding two weeks. The principle indication for use was agitation. Oral benzodiazepines, particularly Lorazepam, were most commonly prescribed and administered followed by Haloperidol. Although high-dose antipsychotics and polypharmacy due to PRN prescribing were common (11 and 20%, respectively), on only 6% of the days studied did patients actually receive PRN antipsychotic medication. Using univariate analyses, PRN administration was associated with younger age, female gender, emotionally unstable personality disorder, shorter length of stay and detention in medium security. Case note documentation of PRN administration was often absent (44%) or vague. Further research, both quantitative and qualitative, is needed into the precise circumstances under which PRN is administered.

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“…Much of the research in this area, however, has been limited to PRN administration documented in handwritten paper medical files, and researchers frequently note limitations deriving from poor documentation of PRN administration that may raise questions about the validity or generalisability of these findings (e.g., Baker et al., ; Curtis & Capp, ; Curtis et al., ; Geffen et al., ; Hales & Gudjonsson, ). Recent innovations in electronic health records (EHR) are intended to standardise documentation, improve communication and reduce errors in patient care, and the EHR is considered a transformational shift over paper charts (Wang, Hailey, & Yu, ).…”

Section: Introductionmentioning

confidence: 99%

Documentation of psychotropic pro re nata medication administration: An evaluation of electronic health records compared with paper charts and verbal reports

Martin

Ham

Hilton

2018

Journal of Clinical Nursing

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Effect of ethnic differences on the use of prn (as required) medication on an inner London medium secure unit

Cited by 14 publications

References 14 publications

The administration of psychotropic PRN medication in Scottish psychiatric intensive care units

The administration of psychotropic PRN medication in Scottish psychiatric intensive care units

A study of the use of sedative PRN medication in patients at a secure hospital

Documentation of psychotropic pro re nata medication administration: An evaluation of electronic health records compared with paper charts and verbal reports

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