Content area
Full Text
Emily-May Barlow presents the findings of a review into the use of 'as required' medication
Abstract
This literature review examines the culture of prn medication within acute inpatient mental health settings. Administering medication on a prn basis largely falls to the judgement of qualified nurses. The themes explored are an overuse and reliance on prn medication, poor documentation surrounding this practice and the need for a standardised assessment. The implications of these are deliberated, including accountability, public image and media coverage (including the Francis Inquiry Report).
Key words
Medication, prn, acute mental health, inpatient, Francis Inquiry Report
Introduction
Pro re nata is a Latin phrase that translates to'in the circumstances'. Within nursing, this term relates to medications administered on an 'as required' basis.
Medication is a common treatment in acute inpatient settings, and acute wards continue to be a critical component of care for acute mental health services despite the ethos of mental health care moving to community based services (Healthcare Commission, 2008).
Within the first week of admission to an acute ward the majority of patients receive medication in accordance with the British National Formulary guidelines (Joint Formulary Committee, 2012). The choice to administer medication on a prn basis falls to the judgement of the qualified nurse as there are currently no specific national guidelines or policies for this routine practice.
As a newly qualified mental health nurse Iwho has relocated to a different country and is therefore working within different policies, guidelines and legislation), the author's concern is that the care governance may not be ideal.
This is a relevant and thought-provoking topic professionally, considering that nursing conduct is accountable under Nursing and Midwifery Council (NMC. 2008) guidelines, which state: 'You are personally accountable for your practice. This means you are answerable for your actions and omissions, regardless of advice or directions from another professional.'
In order to gam an understanding of the situation regarding prn medication within the acute environment a literature search was completed, from which several themes emerged. This paper aims to analyse the literature to establish the circumstances under which it is appropriate to administer prn medication to adults on an acute ward.
Over-reliance on prn medication
Current nursing practice relies on administering prn medication as...