Institute of Psychiatry, Kings College London.
Int J Ment Health Nurs. 2012 Dec;21(6):540-9. doi: 10.1111/j.1447-0349.2012.00834.x. Epub 2012 Aug 1.
This study examined the antecedents to administration of pro re nata (PRN) psychotropic medication on acute psychiatric wards, with a particular focus on its use in response to patient aggression and other conflict behaviours. A sample of 522 adult in-patients was recruited from 84 acute psychiatric wards in England. Data were collected from nursing and medical records for the first 2 weeks of admission. Two-thirds of patients received PRN medication during this period, but only 30% of administrations were preceded by patient conflict (usually aggression). Instead, it was typically administered to prevent escalation of patient behaviour and to help patients sleep. Overall, no conflict behaviours or further staff intervention occurred after 61% of PRN administrations. However, a successful outcome was less likely when medication was administered in response to patient aggression. The study concludes that improved monitoring, review procedures, training for nursing staff, and guidelines for the administration of PRN medications are needed.
本研究考察了在急性精神病病房中开具按需（PRN）精神药物的前因，特别关注其在应对患者攻击和其他冲突行为时的使用。从英格兰 84 个急性精神病病房招募了 522 名成年住院患者作为样本。在入院的前 2 周内，从护理和医疗记录中收集数据。在此期间，三分之二的患者接受了 PRN 药物治疗，但只有 30%的给药是在患者发生冲突（通常是攻击）之前进行的。相反，它通常是为了防止患者行为升级和帮助患者入睡而开具的。总体而言，在 61%的 PRN 给药后，没有发生冲突行为或进一步的员工干预。然而，当药物是为了应对患者的攻击而开具时，治疗效果更不理想。研究得出结论，需要改进监测、审查程序、对护理人员的培训以及 PRN 药物管理指南。
