An intervention regarding the documentation of pro re nata medication in acutely mentally ill adults during medical hospitalizations
Location
Center for Advanced Learning and Simulation (CALS)
Publication Date
April 2025
Start Date
17-4-2025 8:00 AM
Description
Pro re nata (PRN), or "as needed", psychotropic medications such as atypical antipsychotics and anxiolytics are commonly administered to acutely ill patients in the hospital setting. These medications are prescribed for various indications, most commonly for non-redirectable agitation and the symptomatic relief of acute anxiety or insomnia. The use of PRN medications often serves as a guide for adjusting and titrating scheduled medications. However, a frequent issue for a psychiatrist is inadequate documentation of specific indications and problematic behaviors that require PRN medications. This lack of detailed documentation hinders the ability of clinicians to assess the appropriateness and efficacy of the medications, making it difficult to inform future prescribing decisions. This quality improvement (QI) project will assess the rates of documentation supporting PRN medication use on medical and/or surgical floors in patients with acute psychiatric symptoms typically under involuntary holds. We hypothesize that an intervention in the form of flyers and speaking with nurses 1:1 will not only enhance documentation practices but also reduce the frequency of PRN psychotropic medication use, as well as potential misuse, ensuring medications are administered according to their prescribed indications. This intervention may also decrease the overall frequency of PRN psychotropic use as well as misuse not in accordance with prescribed indications. If successful, this initiative could lead to more accurate and consistent documentation practices, and in turn, influence prescribing practices in the future. Additional aims may include the refinement of prescribing protocols based on improved documentation and insights gained through this intervention.
Recommended Citation
Brand, George IV, MD and Culotta, Joshua MD, "An intervention regarding the documentation of pro re nata medication in acutely mentally ill adults during medical hospitalizations" (2025). Dept. of Psychiatry Research Symposium. 21.
https://digitalscholar.lsuhsc.edu/psych_rd/2025/presentations/21
An intervention regarding the documentation of pro re nata medication in acutely mentally ill adults during medical hospitalizations
Center for Advanced Learning and Simulation (CALS)
Pro re nata (PRN), or "as needed", psychotropic medications such as atypical antipsychotics and anxiolytics are commonly administered to acutely ill patients in the hospital setting. These medications are prescribed for various indications, most commonly for non-redirectable agitation and the symptomatic relief of acute anxiety or insomnia. The use of PRN medications often serves as a guide for adjusting and titrating scheduled medications. However, a frequent issue for a psychiatrist is inadequate documentation of specific indications and problematic behaviors that require PRN medications. This lack of detailed documentation hinders the ability of clinicians to assess the appropriateness and efficacy of the medications, making it difficult to inform future prescribing decisions. This quality improvement (QI) project will assess the rates of documentation supporting PRN medication use on medical and/or surgical floors in patients with acute psychiatric symptoms typically under involuntary holds. We hypothesize that an intervention in the form of flyers and speaking with nurses 1:1 will not only enhance documentation practices but also reduce the frequency of PRN psychotropic medication use, as well as potential misuse, ensuring medications are administered according to their prescribed indications. This intervention may also decrease the overall frequency of PRN psychotropic use as well as misuse not in accordance with prescribed indications. If successful, this initiative could lead to more accurate and consistent documentation practices, and in turn, influence prescribing practices in the future. Additional aims may include the refinement of prescribing protocols based on improved documentation and insights gained through this intervention.