Agenda of this article:
PRN chart extra sheet
What is PRN medication?
A PRN medication is a medication that is not required regularly. A PRN, translated from Latin "pro re nata," translates to "as required." can treat many different conditions. The PRN protocol allows you to administer medications or treatments based on the client's specific needs or conditions. They are used when the need arises. It is usually prescribed to treat a short term or intermittent medical condition such as pain, indigestion or insomnia, and may consist of variable doses e.g. Paracetamol 500mg tablets Take ONE or TWO tablets every 4 to 6 hours when required.
They include medicines described as “Emergency Use” or “Rescue” medicines, the use of which should follow common principles of medicines administration applied to particular conditions and circumstances.
“To be taken as required” means medication to be taken when needed,
“Take as needed”. Essentially, it means that you should only take the medication when you really need it.
When do I administer PRN or "when required" medication?
A PRN medication should be administered upon the request of the Care Recipient or when you have observed that it is needed. Consideration should also be given to the Care Recipient's ongoing capacity to refuse the medication.
Please report any suspected tampering with blister packs to the office immediately, as these medications could have been exposed to air and administering them could risk your care recipients' health and safety. Do not administer medication unless you dispensed it yourself.
What is a PRN protocol?
A personalised PRN Protocol is a detailed account of when PRN medication should be administered for a particular recipient. It is needed for all PRN medications whether these are prescribed or self-care. The plan should include appropriate alternative support and interventions to use before medicines are prescribed. If a PRN protocol is not in place for a PRN medication, please contact the office on 020 3970 9900.
How do I administer PRN medication?
When a ‘PRN’ is prescribed, a plan for administering should be documented in PRN protocol and every dose given should be recorded on the PRN chart (including the date, time, dose, signature, remaining, reason for giving and effectiveness of medicine). Please do inform the office of PRN administration by calling us on 020 3970 9900 and a member of our care management team will update the care to clearly support you how to administer PRN medication with the treatment and desired outcome(s) clearly identified.
Procedure:
Check the PRN plan in the care plan.
Ensure there is a PRN protocol in place and if not call the care management team on 020 3970 9900.
Check that there is no duplication of the PRN medication on the MAR chart e.g paracetamol and co-dydramol (which contains paracetamol).
Offer the medication to the care recipient.
The PRN medication must not be offered more frequently than:
the minimum interval between doses, and
the maximum allowed dose in 24 hours.
How do I document PRN medication?
When PRN medicines are administered the record should include:
medication name, form, strength
the reasons for giving the when required medicine
route of administration
how much has been given including if a variable dose has been prescribed
the time of administration for time-sensitive medicines
special instructions/warnings
the outcome and whether the medicine was effective.
The administration of all medication should be recorded on the MAR chart immediately to prevent an incident or accidental overdose from occurring. It is also good practice to record in the client's daily notes when they were offered each PRN medication.
When completing the PRN MAR on the back of the PRN Protocol, you must use every line to document one administration. In some cases you might require an extra sheet for PRN MAR and this will be provided by the office, together with the PRN MAR.
If you are using the extra sheets, please ensure you record the name of the medication and the month in progress and send the MARs together when submitting at the end of the month.
What happens if PRN or "when required" medication is stopped?
Doses already administered must not be crossed out.
Place a line under doses administered and add "stopped {date} on authorisation of {health professional e.g GP or member of edyn care care management team}".
Notify the edyn care management team on 020 3970 9900.
We will update the care plan to reflect PRN being stopped
Any remaining PRN medication should be disposed of, following policy for safe medication disposal.
Ensure GP is aware of this medication being stoped, so that the PRN medication is removed from care recipient repeat medication list on the clinical system.
PRN protocol - Paracetamol example
Care Recipient | Vera Jones | GP Contact | 01482 555 123 |
Date of Birth | 31/05/1963 | Pharmacy Contact | 01482 555 321 |
Address | 24 Rutledge Road, Ipswitch | Known Allergies | IBUPROFEN |
Month & Year of current chart | April 2024 | Level of support required | Level 3 - Administration |
Medication name, form, strength | Paracetamol 500mg tablets Prescribed |
Reason for medication | Pain relief |
Route of administration | Orally |
Prescribed dose | ONE or TWO tablets up to 4 times per day |
Frequency | Four times per day |
Minimal time between doses | 4 hours minimum |
Maximum dose in 24 hours | Do not take more than 2 tablets at a time or 8 tablets in 24hrs. |
Special instructions / warnings | Do not take anything else containing Paracetamol. |
Expected outcome | Relieve pain |
How will you know if a client needs medication | Client will ask for medication |
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| Carer must prompt/offer medication |
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| Carer must assess if the medication is needed | x |
What are the signs and symptoms that may indicate client needs the medication | If the carer observes any signs of discomfort, agitation or other signs that Mrs Jones might be experiencing pain, to ask Mrs Jones if she is in pain and if so, what is her level of pain on a scale from 1 to 10. Based on the answer, the carer will give 1 or 2 tablets to relieve the pain. The carer monitors 30 minutes to see if the outcome is achieved. |
Review date by GP |
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Name and signature of person completing | Beth Smith |
Balance carried over from previous month | 85 tablets |
Date (documented filled out) | 01/04/2024 |
The following occurrences should be reported to the office immediately:
Care Recipient takes the medication consistently for more than a week
Care Recipient always takes the maximum dose or never asks for this medication
Care Recipient asks for more medication than prescribed
There are side effects observed
Expected outcome is not observed
Medication name: _______________________. PRN MAR Month:____________________
Date | Time | Signature | Remaining | Reason for giving and effectiveness of medicine (PRN)
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01/04/24 | 8.30 | BethS | 83 tablets | Mrs Jones seemed agitated and after asking her if she’s in pain, she said her head hurts. Asked her how bad the pain was and she said it was quite bad, an 8-9. Offered 2 tablets of Paracetamol that Mrs Jones took with water. |
01/04/24 | 13.40 | BethS | 82 tablets | After lunch, Mrs Jones was pacing in the kitchen and I asked her if she’s ok. She didn’t know what to say but was very agitated. I asked her if her head still hurts and she said yes. I tried establishing the level of pain but Mrs Jones wasn’t able to say, so I offered 1 tablet of Paracetamol that she had with water. |
01/04/24 | 20.00 | BethS | 80 tablets | In the evening, as I was supporting Mrs Jones to get ready for bed, she kept on putting her hand on her forehead and I asked if she was in pain, she said yes. She went on to say it’s so bad, she probably won’t be able to sleep. I offered her 2 tablets of Paracetamol which she took with water. |
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Please use the extra sheets provided if required. Ensure you record the name of the medication and the month in progress and send the MARs together when submitting at the end of the month.
PRN chart extra sheet
Medication name: _______________________ PRN MAR Month:____________________
Date | Time | Signature | Remaining | Reason for giving and effectiveness of medicine (PRN) |
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If you are using the extra sheets, please ensure you record the name of the medication and the month in progress and send the MARs together when submitting at the end of the month.