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Patient participation in pro re nata medication in forensic psychiatric care: A nursing document analysis.
- Source :
- Journal of Psychiatric & Mental Health Nursing (John Wiley & Sons, Inc.); Aug2021, Vol. 28 Issue 4, p611-621, 11p
- Publication Year :
- 2021
-
Abstract
- Accessible summary: What is known on the subject: As‐needed medication is commonly used for psychiatric inpatients' acute psychiatric and physical symptoms. Both patients and staff can initiate such medication.Earlier studies have focused on what and how as‐needed medication has been used for psychiatric reasons. Little is known about how patients participate in planning, administration and evaluation of as‐needed medication and its alternatives. Nursing documentation provides an insight into these practices. What this paper adds to existing knowledge: Long‐term inpatients have an active role in initiating as‐needed medication. However, patients and staff may have divergent opinions on the need for medication.Alternatives to medication are mostly proposed by staff, and the feedback on as‐needed medication events is usually provided from nurses' point of view. What are the implications for practice: Patients' views on decision‐making and evaluation should be noticed and documented more.Patient participation can be promoted by planning as‐needed medication and its alternatives beforehand. Introduction: Pro re nata (PRN) medication is unscheduled and used for acute physical and psychiatric symptoms. Previous studies have focused on the what and how of psychotropic PRN administration. Initiators of PRN events and occasions in which PRN was denied have rarely been studied. Thus, knowledge of patient participation in PRN is fragmented. Aim: We aimed to describe and explain long‐term psychiatric inpatients' participation in relation to planning and initiation of, as well as decisions and feedback on their PRN medication treatment. Methods: We retrieved data from patients' (n = 67) nursing documentation in a Finnish forensic psychiatric hospital in 2018. Data were analysed using statistical methods. Results: All patients were prescribed PRN, and they initiated half of the 8,626 PRN events identified, in a 1‐year period. Non‐pharmacological strategies were rarely (6%) documented, and most of them were initiated by staff (76%). Feedback on PRN was usually from a nurse's viewpoint (71%). Nurses' feedback was positive (80%) more often than patients' (50%). Discussion: Patient participation needs to be recognized throughout the PRN process. Future research could continue to explore patient participation in planning and evaluating their PRN medication. Implications for practice: Patients participate in PRN by requesting medication. Their participation can be developed by supporting patients to communicate their choice of non‐pharmacological methods, take the initiative for medication when needed and disclose their viewpoint on the effects of PRN. [ABSTRACT FROM AUTHOR]
- Subjects :
- DRUG therapy for psychoses
PSYCHIATRIC nursing
STATISTICS
PATIENT participation
SCIENTIFIC observation
PSYCHOSES
CROSS-sectional method
ATTITUDES of medical personnel
RETROSPECTIVE studies
ACQUISITION of data
MANN Whitney U Test
DOCUMENTATION
PATIENTS' attitudes
DECISION making
NURSES
PATIENTS' rights
MEDICAL records
DESCRIPTIVE statistics
DRUGS
FORENSIC psychiatry
DATA analysis
DATA analysis software
PSYCHIATRIC treatment
ANTIPSYCHOTIC agents
LONG-term health care
PSYCHIATRIC hospitals
CRISIS intervention (Mental health services)
Subjects
Details
- Language :
- English
- ISSN :
- 13510126
- Volume :
- 28
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Journal of Psychiatric & Mental Health Nursing (John Wiley & Sons, Inc.)
- Publication Type :
- Academic Journal
- Accession number :
- 151330341
- Full Text :
- https://doi.org/10.1111/jpm.12706