Abstract
Objective
To investigate administration of pro re nata (PRN) medications and nurse-initiated
medications (NIMs) in Australian aged care services over a 12-month period.
Design
Twelve-month longitudinal audit of medication administrations.
Setting and participants
Three hundred ninety-two residents of 10 aged care services in regional Victoria,
Australia.
Methods
Records of PRN and NIM administration were extracted from electronic and hard copy
medication charts. Descriptive statistics were used to calculate medication administration
per person-month. Poisson regression was used to estimate predictors of PRN administration.
Results
Over a median follow-up of 12 months (interquartile range 10–12 months), 93% of residents
were administered a PRN medication and 41% of residents an NIM on 21,147 and 552 occasions,
respectively. The mean number of any PRN administration was 5.85 per person-month.
The most frequently administered PRN medications per person-month were opioids 1.54,
laxatives 0.96, benzodiazepines 0.72, antipsychotics 0.48, paracetamol 0.46, and topical
preparations 0.42. Three-quarters of residents prescribed a PRN opioid or PRN benzodiazepine
and two-thirds of residents prescribed a PRN antipsychotic had the medication administered
on 1 or more occasions over the follow-up.
Conclusions and Implications
Most residents were administered PRN medications. Administration was in line with
Australian regulations and institutional protocols. However, the high frequency of
PRN analgesic, laxative, and psychotropic medication administration highlights the
need for regular clinical review to ensure ongoing safe and appropriate use.
Keywords
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Article info
Publication history
Published online: June 28, 2020
Footnotes
BA and LMC are employed by health services overseen by the Department of Health and Human Services.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
