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PRN MedicationsPRN Medications

Medication Education Module 6Medication Education Module 6

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LOGO ObjectivesObjectives

1. 1. What is a PRN Medication? What is a PRN Medication? 1. 1. What is a PRN Medication? What is a PRN Medication?

2. 2. When are PRNs given? When are PRNs given? 2. 2. When are PRNs given? When are PRNs given?

3. 3. What are parameters?What are parameters?3. 3. What are parameters?What are parameters?

4. 4. How do you document a PRN? How do you document a PRN? 4. 4. How do you document a PRN? How do you document a PRN?

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LOGO PRNPRNAbbreviationAbbreviationMeds ordered to Meds ordered to be given as be given as neededneeded

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LOGO PRN OrdersPRN Orders Must Include:Must Include:

FrequencyFrequency Indication(s)Indication(s)

Specific target signs Specific target signs and symptomsand symptoms

Instructions for useInstructions for use ParametersParameters

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LOGO ParametersParameters A limit of doses within a A limit of doses within a

certain time framecertain time frame and/orand/or When to notify the HCP When to notify the HCP

if symptoms continueif symptoms continue

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LOGO PRN OrdersPRN Orders NoNo Ranges Ranges For example:For example:

2 tabs 2 tabs NOTNOT 1-2 tabs 1-2 tabs 10 mls 10 mls NOTNOT 5-10mls 5-10mls Every 4 hrs Every 4 hrs NOTNOT every 4-6 hrs every 4-6 hrs 3 times per day 3 times per day NOTNOT 2-3 times 2-3 times

per dayper day

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LOGO Frequency of PRNSFrequency of PRNS ExamplesExamples

Every 4 hrs as neededEvery 4 hrs as needed Every 6 hrs as neededEvery 6 hrs as needed Once daily as neededOnce daily as needed Every 3Every 3rdrd day as needed day as needed

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LOGOName: Chip BrownName: Chip Brown Date: 6/1/yrDate: 6/1/yr

Health Care Provider: Dr. JonesHealth Care Provider: Dr. Jones Allergies: no known allergiesAllergies: no known allergies

Reason for Visit: Chip has been pacing more than usual, slapping his head and telling Reason for Visit: Chip has been pacing more than usual, slapping his head and telling staff he feels weird inside.staff he feels weird inside.

Current Medications: Current Medications: See attached med listSee attached med list

Staff Signature:Staff Signature:

John Smith, Program John Smith, Program ManagerManager

Date: 6/1/yrDate: 6/1/yr

Health Care Provider Findings: After discussing with Chip about how he is feeling we Health Care Provider Findings: After discussing with Chip about how he is feeling we have agreed to try additional Ativan to help him feel less anxious.have agreed to try additional Ativan to help him feel less anxious.

Medication/Treatment Orders:Medication/Treatment Orders:Add Ativan 0.5 mg once daily PRN anxiety by mouthAdd Ativan 0.5 mg once daily PRN anxiety by mouthGive at least 4 hrs apart from regularly scheduled Ativan doses.Give at least 4 hrs apart from regularly scheduled Ativan doses.Refer to Behavior Support Plan.Refer to Behavior Support Plan.Continue with current medications:Continue with current medications:Ativan 0.5mg twice daily by mouthAtivan 0.5mg twice daily by mouthCapoten 25mg one time a day in the morning by mouth.Capoten 25mg one time a day in the morning by mouth.

InstructionsInstructions:

Follow-up visit:Follow-up visit: Lab work or TestsLab work or Tests:

Signature: Signature: Dr. JonesDr. Jones Date: 6/1/yrDate: 6/1/yr

HEALTH CARE PROVIDER ORDERHEALTH CARE PROVIDER ORDER

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LOGO Support Plan for use of PRN Medication for AnxietySupport Plan for use of PRN Medication for Anxiety

Specific behaviors that show us Chip is anxious:Specific behaviors that show us Chip is anxious:1.1. Pacing in a circle for more than 4 minutes.Pacing in a circle for more than 4 minutes.2.2. Head slapping for longer than 30 seconds or more than 5 times Head slapping for longer than 30 seconds or more than 5 times

in 4 minutes.in 4 minutes.

A.A. Staff will attempt to engage Chip in one on one conversation re: Staff will attempt to engage Chip in one on one conversation re: current feelings and difficulty.current feelings and difficulty.

B.B. Staff will attempt to direct and involve Chip in a familiar activity Staff will attempt to direct and involve Chip in a familiar activity such as laundry, meal preparation, etc.such as laundry, meal preparation, etc.

If unsuccessful with A or B staff may suggest/offer Chip: If unsuccessful with A or B staff may suggest/offer Chip: Ativan 0.5mg once daily as needed by mouth. Must give at least Ativan 0.5mg once daily as needed by mouth. Must give at least 4 hours apart from regularly scheduled Ativan doses. 4 hours apart from regularly scheduled Ativan doses. (Refer to HCP order) (Refer to HCP order) If anxiety continues after the additional dose, notify HCP.If anxiety continues after the additional dose, notify HCP.

6/1/yr Dr Jones6/1/yr Dr Jones

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LOGO Pharmacy LabelPharmacy LabelRx # C138 ABC Pharmacy 555-555-1212Rx # C138 ABC Pharmacy 555-555-1212

20 Main Street20 Main Street

Anytown, MA 09111 8/31/yrAnytown, MA 09111 8/31/yr

Chip BrownChip Brown

Lorazepam 0.5 mg Qty. 30Lorazepam 0.5 mg Qty. 30

I.C. Ativan 0.5 mgI.C. Ativan 0.5 mg

Take 1 tablet by mouth twice daily and 1 tablet by Take 1 tablet by mouth twice daily and 1 tablet by mouth once daily PRN, anxiety, give at least 4 hrs apart mouth once daily PRN, anxiety, give at least 4 hrs apart from regularly scheduled doses, see behavior plan.from regularly scheduled doses, see behavior plan.

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Med Sheet in the corresponding Med Sheet in the corresponding date/time boxdate/time box Your initialsYour initials Time Time

Progress NoteProgress Note Medication and dose Medication and dose Your nameYour name Date and time Date and time Medication effectivenessMedication effectiveness

DocumentationDocumentation

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Name: Chip Brown Month/Year:Sept, yr Allergies:NKDA

Dates Medication Hour 1 2 3 4 5 6

Start: 6-1-yr

Generic: Lorazepam Brand: Ativan

P

Strength: 0.5mg Amount:1 tab

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Stop: Cont.

Dose: 0.5mg Route: by mouth Frequency:once daily PRN anxiety

N

3pm

KM

SPECIAL INSTRUCTIONS/REASON: Anxiety- See Behavior Support Plan. Must give at least 4 hrs apart from regularly scheduled Ativan doses

Medication SheetMedication Sheet

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LOGO Progress Note Progress Note 9/1/yr 3pm Chip is 9/1/yr 3pm Chip is pacing and head pacing and head slapping, unable to slapping, unable to redirect, Ativan redirect, Ativan 0.5mg by mouth 0.5mg by mouth given. 4pm, watching given. 4pm, watching TV and smiling. TV and smiling. Kathy MasonKathy Mason

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LOGO CrosscheckingCrosscheckingMust agreeMust agree

HCP OrdersHCP Orders Pharmacy LabelsPharmacy Labels Med SheetsMed Sheets

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LOGO QuestionsQuestions