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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao International Journa...arrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
International Journal of Mental Health Nursing
Article . 2017 . Peer-reviewed
License: Wiley Online Library User Agreement
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Analysis of non‐pharmacological interventions attempted prior to pro re nata medication use

Authors: Krystle, Martin; Vinita, Arora; Ilan, Fischler; Renee, Tremblay;

Analysis of non‐pharmacological interventions attempted prior to pro re nata medication use

Abstract

AbstractThe aim of the present study was to elucidate what non‐pharmacological interventions are applied by nursing staff prior to the administration of psychotropic pro re nata (PRN) medication. Best practices would instruct clinical staff to provide non‐pharmacological strategies, such as de‐escalation and skills coaching, as the first response to patient distress, anxiety, or agitation. Non‐pharmacological strategies might be safer for patients, promote more collaborative relationships, and facilitate greater skills development for managing symptoms. The literature has highlighted that poor documentation of pre‐PRN administration interventions has limited our understanding of this practice, but evidence suggests that when this information is available, non‐pharmaceutical approaches are not being attempted in the majority of cases. This is troubling given that, while clinically appropriate in some instances, PRN have been subject to criticism and lack critical evidence to support their use. The current study is a continuation of our previous work, which examined the reason, frequency, documentation, and outcome (e.g. effectiveness, side‐effects) of PRN medication use at our facility. A chart review was conducted to understand what happens prior to the administration of PRN medication at our facility across all inpatient units over the course of 3 months. Results support previous findings that non‐pharmacological interventions are poorly documented by front‐line staff and are seemingly used infrequently. The use of these interventions differs by patient presentation (e.g. agitation, insomnia), and most often include supportive measures. The findings suggest that both documentation and intervention practices of nursing staff require further investigation and adjustment to align with best practices.

Keywords

Adult, Aged, 80 and over, Hospitals, Psychiatric, Male, Psychotropic Drugs, Adolescent, Mental Disorders, Anxiety, Middle Aged, Aggression, Young Adult, Psychotic Disorders, Sleep Initiation and Maintenance Disorders, Humans, Female, Psychomotor Agitation, Aged, Retrospective Studies

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
14
Top 10%
Average
Top 10%
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