Implementing Safe Practices in Administering Pro re nata Medications in a Rural Hospital

Hogan, Kerry-Anne; Lapenskie, Julie; Leclair, Joanne; Thick, Naomi; Gazarin, Mohamed; Webster, Penny; Devin, Brian

doi:10.1097/pts.0000000000000276

Cited by 2 publications

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“…The safety of PRN medicines management is influenced by healthcare professionals’ knowledge and skills, and the healthcare culture ( Morkunas et al, 2016 ). The decision for the use of PRN medications are taken in collaboration with the physician, nurse, patient, and families, but it is accompanied by the risk of errors due to their distinct interpretations of the medication process ( Hogan et al, 2019 ). Ambiguities in PRN medicines management including indication for prescription, method of administration, and complete documentation can adversely impact patient care outcomes, increase the risk of polypharmacy, adverse drug events, and abuse ( Friedman et al, 2012 ; Oh et al, 2014 ; Hammer et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Practical Considerations of PRN Medicines Management: An Integrative Systematic Review

et al. 2022

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Background and objectives: Highly widespread use of pro re nata (PRN) medicines in various healthcare settings is a potential area for improper medication prescription and administration leading to patient harm. This study aimed to summarize and integrate the findings of all relevant individual studies regarding the practical considerations of PRN medicines management including strategies and interventions by healthcare professionals for safe prescription, dispensing, administration, monitoring, and deprescription of PRN medicines in healthcare settings.Methods: An integrative systematic review on international databases were performed. Electronic databases including Web of Knowledge, Scopus, PubMed (including MEDLINE), and Cinahl were searched to retrieve articles published until end of May 2021. Original qualitative, quantitative, and mixed methods studies written in English were included with a focus on PRN medicines management in healthcare settings. Research synthesis using the narrative method was performed to summarise the results of included studies.Results: Thirty-one studies on PRN medicines in healthcare settings by different healthcare providers were included after the screening of the databases based on eligibility criteria. They were published from 1987 to 2021. The majority of studies were from Australia, the United States, Canada, and the United Kingdom and were conducted in psychiatric settings. Given variations in their purposes, methods, and outcomes, the research synthesis was conducted narratively based on diversities and similarities in findings. Eight categories were developed by the authors as follows: “PRN indications and precautionary measures,” “requirements of PRN prescription,” “interventions for PRN administration,” “monitoring and follow up interventions,” “deprescription strategies,” “healthcare professionals’ role,” “participation of patients and families,” and “multidisciplinary collaboration.” Each category consists of several items and describes what factors should be considered by healthcare professionals for PRN medicines management.Conclusion: The review findings provide insights on the practical considerations of PRN medicines management in clinical practice. The suggested list of considerations in our review can be used by healthcare professionals for optimal PRN medicines management and safeguarding patient care.

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Section: Introductionmentioning

confidence: 99%

Practical Considerations of PRN Medicines Management: An Integrative Systematic Review

et al. 2022

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“…Consequently, rural primary care has unique challenges, often involving complex medical cases and limited resources [6,[11][12][13][14][15][16][17]. To tackle these problems, previous studies have suggested various approaches, such as strengthening multiprofessional collaboration [18][19][20][21][22][23], establishing remote pharmacy services [18,19], and developing public health programs aiming at medication process evaluation and enhanced safety of care providers [24,25]. To systematically control the risks associated with the medication process, rural primary care units could bene t from introducing proactive approaches, such as medication safety self-assessment (MSSA), to uncover the central risk points of care [16].…”

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confidence: 99%

Developing a medication-safety self-assessment tool for rural primary care units - A case from Finnish Lapland

Sova,

Celikkayalar,

Sneck

et al. 2024

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Background In rural areas, primary care faces several challenges, and medication therapy is one of the most complex processes in primary care. With a specific, proactive, medication-safety self-assessment tool designed for rural primary care units, healthcare professionals could identify development needs in their medication processes. Methods The Delphi consensus method with two Delphi rounds was used to create a medication-safety self-assessment tool for rural primary care units in Finnish Lapland. A preliminary tool was designed based on three national and international risk management tools. Statements of the preliminary tool were evaluated with a two-round Delphi panel by 12 experts in primary care and patient safety. Evaluated aspects were suitability for primary care settings, patient safety relevance, and necessity of the statements to be included in the developed rural, primary care, medication-safety self-assessment tool. Results In the first Delphi round, a consensus was reached on 39% of the statements (n = 118/304), of which 86% (n = 101/118) were included, and 14% (n = 17/118) were excluded from the final primary care medication- safety self-assessment tool. In the second round, 84% of the statements (n = 141/167) reached a consensus, of which 70% (n = 98/141) were excluded and 30% (n = 43/141) included in the final tool. The included 144 statements were divided into 12 thematic sub-groups: 1. Patient information, 2. Drug information, 3. Communication of drug orders and other drug information; 4. Drug labeling, packaging and nomenclature; 5. Drug storage and distribution, 6. Medication device acquisition and use, 7. Environmental factors, workflow and staffing patterns; 8. Staff competency and education, 9. Patient education, 10. Preventive risk management, 11. Learning from medication safety incidents, and 12. Electronic health record. Conclusions The developed medication-safety self-assessment tool is targeted for proactive medication risk management in rural primary care settings. While experts reached a consensus for the PMSSA tool contents, adoption of the tool to suit the rural primary care environments in different countries should be further investigated.

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Implementing Safe Practices in Administering Pro re nata Medications in a Rural Hospital

Cited by 2 publications

References 4 publications

Practical Considerations of PRN Medicines Management: An Integrative Systematic Review

Practical Considerations of PRN Medicines Management: An Integrative Systematic Review

Developing a medication-safety self-assessment tool for rural primary care units - A case from Finnish Lapland

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