What is PRN Medication?
PRN (from Latin "pro re nata" meaning "as the situation demands") medications are prescribed to be given when needed rather than at fixed times. Common examples include pain relief, anti-anxiety medication, laxatives, and sleep aids.
PRN medication requires clear documentation to ensure it's given appropriately, not overused, and its effectiveness is monitored.
Creating PRN Protocols
Each PRN medication should have an individual protocol specifying:
Indication
What symptoms/circumstances warrant giving this medication?
Assessment
How should staff assess whether PRN is needed? (e.g., pain scale)
Dose
What dose should be given? Any variation based on response?
Maximum frequency
How often can it be given? Minimum interval between doses?
Maximum in 24 hours
Maximum number of doses or total amount per day
Alternatives tried
What non-pharmacological interventions should be tried first?
Effectiveness review
How long to wait and how to assess if it worked?
Escalation
When to contact GP if PRN not controlling symptoms?
Example PRN Protocol
Paracetamol 500mg Tablets PRN
Indication: Mild to moderate pain, headache, fever
Assessment: Ask resident about pain using verbal scale 0-10. For non-verbal residents, use Abbey Pain Scale.
Dose: 1-2 tablets (500mg-1g)
Maximum: Every 4-6 hours, maximum 8 tablets (4g) in 24 hours
Try first: Repositioning, heat/cold packs, distraction
Review: Reassess pain 1 hour after administration
Escalate: Contact GP if pain not controlled after 3 doses
Documenting PRN Administration
Every time PRN medication is given, record:
- Date and exact time
- Reason for giving (specific symptoms)
- Assessment result (e.g., pain score of 7/10)
- Dose given
- Staff member administering
- Effectiveness review outcome
Reason is Essential
"PRN given" is not acceptable documentation. Always record the specific reason: "Given for headache, pain reported as 6/10" or "Given for anxiety prior to hospital appointment as discussed with resident."
Effectiveness Recording
Document effectiveness 30-60 minutes after administration:
- Did symptoms improve?
- New assessment score (e.g., pain now 2/10)
- Any side effects observed
- Resident's feedback in their words
PRN for Behaviour Management
PRN medication for anxiety or behaviour requires extra care:
- Person-specific protocol detailing exact circumstances
- Non-pharmacological interventions always tried first
- Regular review of usage patterns
- Must not be used as "chemical restraint"
- Consider capacity and best interests
Monitoring PRN Usage
Review PRN usage patterns regularly:
- Frequency of use - increasing, stable, decreasing?
- Time patterns - always at certain times?
- Effectiveness - working consistently?
- Conversion to regular - if used frequently, should it be regular?
- Unused PRN - still needed on prescription?
Common PRN Documentation Issues
- No protocol in place
- Reason not documented
- Effectiveness not recorded
- Maximum doses exceeded without GP contact
- Used without trying alternatives first
- Protocol not specific to individual
CQC Expectations
Inspectors will check:
- Individual PRN protocols for each resident
- Clear documentation of reasons for each administration
- Evidence of effectiveness monitoring
- Regular review of PRN usage
- Appropriate use (not as first resort or restraint)
Related Medication Guides
PRN Documentation Made Simple
Revitaco prompts for PRN reasons, reminds staff to record effectiveness, and tracks usage patterns automatically.
Book Your Demo