title: Behavioural antecedents to pro re nata psychotropic medication administration on acute psychiatric wards.
abstract: This study examined the antecedents to administration of pro re nata (PRN) psychotropic medication on acute psychiatric wards, with a particular focus on its use in response to patient aggression and other conflict behaviours. A sample of 522 adult in-patients was recruited from 84 acute psychiatric wards in England. Data were collected from nursing and medical records for the first 2  weeks of admission. Two-thirds of patients received PRN medication during this period, but only 30% of administrations were preceded by patient conflict (usually aggression). Instead, it was typically administered to prevent escalation of patient behaviour and to help patients sleep. Overall, no conflict behaviours or further staff intervention occurred after 61% of PRN administrations. However, a successful outcome was less likely when medication was administered in response to patient aggression. The study concludes that improved monitoring, review procedures, training for nursing staff, and guidelines for the administration of PRN medications are needed.
authors.affiliation: Institute of Psychiatry, Kings College London. duncan.stewart@kcl.ac.uk
authors.forename: Duncan
authors.initials: D
authors.lastname: Stewart
authors.forename: Deborah
authors.initials: D
authors.lastname: Robson
authors.forename: Robert
authors.initials: R
authors.lastname: Chaplin
authors.forename: Alan
authors.initials: A
authors.lastname: Quirk
authors.forename: Len
authors.initials: L
authors.lastname: Bowers
mesh_terms: D000328:Adult; D000374:Aggression / Q000187:drug effects / Q000523:psychology; D003220:Conflict, Psychological; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012893:Sleep Wake Disorders / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs