Medicines Policy for Care Staff trained and competent to administer medicines
Title: Procedure for administration of PRN or ‘as required ’medication
Date
Review date
Purpose of this document
This procedure for the administration of when required (PRN) medication
is to provide consistency of treatment for the service user.
Competencies required
To successfully complete the medicines training and update sessions
To complete the competencies and to be able to demonstrate the required
skills and knowledge to ensure safe practice.
To adhere to the standards specified in this Policy
People covered
All service users.
Procedure: Administration of When Required (PRN) Medication
Medication with a ‘when required’ dose (PRN) is usually prescribed to treat
short term or intermittent medical conditions i.e. it is not to be taken
regularly. Medicines used to treat nausea or vomiting following a specific
treatment regime as an example, are often taken by people who are
experiencing symptoms irregularly. In such circumstances the person may
not need the tablets every day.
To ensure the medication is given as intended a specific plan for
administration must be recorded in the care plan and ideally kept with the
MAR charts. Information on why the medication has been prescribed and
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how to give it should be sought from the prescriber, the supplying
pharmacist or other healthcare professionals involved in the treatment of
the person.
Consideration should be given to the person’s capacity to refuse the
medication. When providing staff with information the needs of the person
must be identified e.g. if signs of pain are expressed in a non-verbal way.
A record does not have to be made at each medicine round to show the
person has been offered the medication. However the care plan should
demonstrate that staff know what the medication is for and have made an
assessment on whether the person requires the medication.
PRN medication should not be offered or given only at the times listed on
the MAR chart or at specific medication rounds. As it is for occasional use
the person should be offered the medication at the times they are
experiencing the symptoms either by telling a member of staff or by staff
identifying the person’s need as outlined in the care plan. The exact time
the medication was given and the amount given should be recorded on the
MAR.
If PRN medication is given regularly then a referral to the prescriber should
be considered for a review of the person’s medication, as their medical
condition may have changed and the treatment required may need
altering. Similarly if the medication is not having the expected effects the
prescriber should be contacted. In both cases the response to the
medication should be clearly recorded.
PRN medication that is still in use and in date should be carried over from
one month to the next and not disposed of. A record of the quantity carried
over should be recorded on the new MAR so there is an accurate record of
the quantity in stock and to help when performing audits.
PRN medication is best supplied in an original box rather than a monitored
dosage system (MDS). This allows for a check on the expiry date and
reduces waste.
PRN or ‘when required’ medicines must be given in accordance with the
prescribers instructions, details of which should be recorded on the Care
Plan and on the MAR chart. If the instructions are not clear, clarification
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needs to be sought from the prescriber and a PRN Medication Instructions
Form completed. This form will detail the maximum dosage in 24 hours,
how often the dose can be repeated and details of how and when the
medication should be given.The form should be signed by the prescriber
and by the person requesting the clarification or receiving the information.
This procedure should be adopted for any service users prescribed “when
required” (PRN) medication which does not contain clear directions.
The Care Manager should ensure completion of form Information from
the Prescriber – PRN Instructions by the prescriber whenever
clarification is needed.
If the form Information from the Prescriber – PRN Instructions has not
been completed, the care worker will be unable to administer the drug.
The Care Manager must obtain full information. If necessary, further
information and advice should be sought from the prescriber. This
includes medication prescribed by a hospital prescriber.
The form Information from the Prescriber – PRN Instructions must be
made available to the care worker and placed in the Residents Records
next to the MAR.
The care worker must consult the form Information from the Prescriber
– PRN Instructions before administration of the medication.
Immediately after witnessing the administration of medication, the care
worker must document the dose, time and reason for administration e.g.
pain or constipation on the MAR.
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Standards:
Written Information is available for
staff to know how to administer the
medication
Staff know what the
medication has been
prescribed for
Staff know when to give the
medication or ask the person if they
need it. Staff know what symptoms to
look out for
A written record makes clear
the maximum amount to be
given in a day or the time to
leave between doses
Staff offer the medication at times
other than the usual medication
rounds
Relevant records are clearly
made on the MAR chart
The medication policy and procedure
cover the administration of PRN
medication
Care plans provide detailed
information on medication
prescribed as ‘when required’
Staff understand what the medication
is for
If PRN medication is given
regularly there are regular
reviews taking place
PRN medication is offered at times to
meet the needs of the person
There are accurate records of
administration made
PRN medications are held in suitable
quantities and are in date
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Information from the Prescriber – PRN Instructions
PRN (WHEN REQUIRED) MEDICATION INSTRUCTIONS
Name of Service User:
DOB:
Address:
Medication
Dose
Reason for Medication
Dosage Criteria
E.g.
Give 1 if…………….
Give 2 if…………….
How often dose can be
repeated
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Max in 24 hours
Further info. e.g. after
food
Review Date
Circumstances for
reporting to GP
Tick  as appropriate
 Persistent need for upper level of
dosage
 Never requesting dosage
 Requesting too often
 Side effects experienced
 Other (please state)
Prescribers Signature: ………………………………….Date……………..
Person seeking clarification/receiving information
Signature…………………………………… Date………………………..
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