Document Detail


The impact of a good practice manual on professional practice associated with psychotropic PRN in acute mental health wards: an exploratory study.
MedLine Citation:
PMID:  18313059     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: As required or pro re nata (PRN) psychotropic medicines are frequently used in acute mental health wards. PRN is known to contribute to polypharmacy and high doses of antipsychotic medication. Few studies have attempted to improve clinician's use of these potentially harmful drugs. AIMS: The objectives of the study were to determine the impact and acceptability of a good practice manual on prescribing and administration practices of PRN psychotropic medication in acute mental health wards. DESIGN: The study used a pre-post exploratory design with two acute mental health wards in the NW of England. RESULTS: Over the total trial period of 10 weeks, 28 of 35 patients received 484 doses of PRN. Patients had a mean of 3.6 prescriptions of 14 different PRN medications in 34 different dose combinations prescribed. Medication errors beyond poor quality of prescribing occurred in 23 of the 35 patients (65.7%). Prescription quality improved following the introduction of the intervention but quality of nursing notes reduced. Acceptability of the manual to both nursing and medical staff was high. CONCLUSION: The introduction of the manual appeared to influence some of the practices associated with the prescribing and administration of PRN psychotropic medications. Further, larger, more robust studies are required in this area. In particular research is required to identify the reasons why professionals continue to rely so heavily on using PRN medication.
Authors:
J A Baker; K Lovell; N Harris
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2008-03-04
Journal Detail:
Title:  International journal of nursing studies     Volume:  45     ISSN:  0020-7489     ISO Abbreviation:  Int J Nurs Stud     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-03     Completed Date:  2009-01-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400675     Medline TA:  Int J Nurs Stud     Country:  England    
Other Details:
Languages:  eng     Pagination:  1403-10     Citation Subset:  IM; N    
Affiliation:
The School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, M13 9PL, UK. john.a.baker@manchester.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Attitude of Health Personnel
Benchmarking / organization & administration*
Chi-Square Distribution
Drug Administration Schedule
Drug Prescriptions / nursing,  standards
Drug Utilization Review
England
Humans
Manuals as Topic / standards*
Medication Errors / nursing,  prevention & control,  statistics & numerical data
Mental Disorders* / drug therapy,  nursing
Nursing Assessment
Nursing Audit
Nursing Evaluation Research
Nursing Records / standards
Nursing Staff, Hospital / education,  organization & administration,  psychology
Patient Education as Topic / standards
Polypharmacy
Psychiatric Nursing / education,  organization & administration*
Psychotropic Drugs / administration & dosage*,  adverse effects
Statistics, Nonparametric
Total Quality Management / organization & administration
Chemical
Reg. No./Substance:
0/Psychotropic Drugs

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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