Usher K, Lindsay D, Sellen J
School of Nursing Sciences, James Cook University, Townsville, Queensland 4811, Australia.
J Psychiatr Ment Health Nurs. 2001 Oct;8(5):383-90. doi: 10.1046/j.1365-2850.2001.00407.x.
PRN psychotropic medications (medications given with the aim of changing the patient's mental state on an 'as needed' basis) are frequently prescribed and administered in mental health facilities. Their administration is largely an autonomous nursing role. However, little research has explored this important area of nursing practice in any detail and therefore the use of this intervention by mental health nurses is not fully understood. A descriptive project was undertaken to explore the factors involved in the administration of PRN psychotropic medications. It utilized a retrospective chart audit, conducted at one regional and one urban setting in Queensland, Australia. The results indicate a lack of clarity surrounding psychotropic PRN medication administration practices, confusion surrounding decision-making processes related to this intervention, and poor documentation practices. The study found a high incidence of PRN psychotropic medication administration when compared to similar studies, and an excessive reliance on the use of typical antipsychotics over benzodiazepines. This practice is not supported by contemporary literature. As a result of our findings, we recommend further studies in areas of related importance, in order to increase our understanding of the complexities surrounding this important nursing intervention, and an investigation into documentation practices in inpatient mental health settings.
按需使用的精神药物（即旨在“根据需要”改变患者精神状态而给予的药物）在精神卫生机构中经常被开具和使用。其给药在很大程度上是护士的自主职责。然而，几乎没有研究详细探讨过这一重要的护理实践领域，因此精神科护士对这种干预措施的使用情况尚未得到充分了解。开展了一个描述性项目，以探究按需使用精神药物给药过程中涉及的因素。该项目采用回顾性病历审核，在澳大利亚昆士兰州的一个地区和一个城市环境中进行。结果表明，精神药物按需给药的实践缺乏明确性，与该干预措施相关的决策过程存在混乱，且记录做法不佳。与类似研究相比，该研究发现按需使用精神药物的发生率较高，且过度依赖使用典型抗精神病药物而非苯二氮䓬类药物。当代文献并不支持这种做法。基于我们的研究结果，我们建议在相关重要领域开展进一步研究，以增进我们对围绕这一重要护理干预措施的复杂性的理解，并对住院精神卫生环境中的记录做法进行调查。
