Background The use of ‘as required’ (PRN) medication provides relief from symptoms and guides adjustment of regular medication. Previous studies have looked at PRN medication prescribed for hospice patients (Russell, Rowett & Currow, 2014; Sera, McPherson & Holmes, 2014) but not PRN medication administered. The time taken to administer PRN medication on an orthopaedic post-operative unit has been studied (Pizzi, Chelly & Marlin, 2014) but there is no data for a hospice setting.
Aim To establish how many and which PRN medications are administered in a hospice in-patient unit and identify factors correlating with the number of PRNs given. To look at the feasibility of measuring time taken to give PRNs in a hospice.
Method We collected prospective data from all the patients’ prescription charts on the in-patient unit over a 28 day period (September 2017). We recorded:
Patient demographic details
The number and type of PRN medication administered, route of administration and time of day
Length of time to administer PRN medication and suggestions from staff on improving the process.
We scrutinised staffing levels, number of admissions, discharges and deaths over this period.
Conclusions The number of PRNs given may reflect the complexity and variability of patient symptoms and their active management within the hospice. It may also highlight that the management of the background medications needs more proactively reviewing. The baseline data is allowing us to learn and look at approaches to improve patient symptom outcomes as well as maximising nursing and medical time. Further benchmarking data would be helpful.
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