Medication to be “Taken as Required” Policy
This policy should be read in relation to the home’s other medication policies.
Most medication is prescribed with clear instructions of how much should be taken and how often.
However, some medication is prescribed on a “taken as required” dose, sometimes abbreviated as PRN (pro re nata). “To be taken as required” means medication to be taken when needed, eg when a person is in pain. Some non-prescribed medication (see Homely Remedies Policy) can also be taken as required depending on the reasons for its use.
Such medication is usually prescribed to treat short-term or intermittent medical conditions and is not to be taken regularly. Painkillers are commonly prescribed on a PRN basis or obtained on an over-the-counter basis.
All such medication will be supplied from the pharmacist with its patient information leaflet detailing the limits in which it can be safely used, in terms of amounts and frequency, and whether it might interact adversely with other medication being taken. This information must always be studied, observed and kept with the medication.
To ensure that medication is given as intended, a specific plan for administration of PRN medication is recorded in the residents care plan and administration details recorded on the MAR charts. The care plan must state clearly what the medication is for and the circumstances in which it might be given.
For example, a resident who has been prescribed a PRN anti-emetic will have an entry to state that the medication is used to treat nausea or vomiting. Staff will then make an assessment to decide whether or not the medication can be given safely. It is important to check with the resident what their needs and wishes are.
Records should show that PRN medication is not only offered or given during specific medication rounds but is given whenever the resident requires it, ie whenever they are experiencing symptoms. The exact time the medication is given and the amount given must be recorded on the MAR chart, details indicating that it has been given to meet a specific need and the results of giving the PRN medication must be entered on the reverse of the MAR chart.
When PRN medication is being given on a regular or increasing basis or the resident appears to becoming dependent on it, the home will contact the prescriber to review its use. For instance, if a resident is taking painkillers more often this might signal a change in their medical condition. Alternatively, where PRN is no longer required it may need to be discontinued.
In line with recommended practice the home tries to make sure that PRN medication is supplied in its original box rather than in any monitored dosage system as this allows for a check on the expiry date and reduces waste.
The home monitors and regularly reviews together with the residents GP the usage of PRN medication to make sure that it is following current best practice pharmaceutical guidance.
Staff are made aware of the policy and procedures on PRN medication as part of their induction and further ongoing training and competency in safe handling, administration, storage and disposal of all medication and drugs used in the home.
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