Discontinuing the Use of PRN Intramuscular Medication for Agitation in an Acute Psychiatric Hospital

This study examined the impact of eliminating intramuscular PRN medication for agitation on patient and staff safety in an acute psychiatric inpatient setting. The current retrospective chart review investigated the use of PRN medications (oral and intramuscular) to treat acute agitation, including...

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Bibliographic Details
Published in:Psychiatric quarterly 2016-03, Vol.87 (1), p.25-29
Main Authors: Hayes, Ariel, Russ, Mark J.
Format: Article
Language:English
Subjects:
Acute
Acute services
Administration, Oral
Adult
Aggressiveness
Agitation
Assaults
Chart reviews
Diphenhydramine - administration & dosage
Diphenhydramine - therapeutic use
Drug Utilization - statistics & numerical data
Drug Utilization - trends
Drugs
Female
Haloperidol - administration & dosage
Haloperidol - therapeutic use
Hospitalization
Hospitals, Psychiatric
Humans
Injections, Intramuscular
Lorazepam - administration & dosage
Lorazepam - therapeutic use
Male
Medicine
Medicine & Public Health
Mental disorders
Mental health
Middle Aged
Original Paper
Patient Safety - statistics & numerical data
Psychiatry
Psychomotor Agitation - drug therapy
Psychotropic drugs
Public Health
Retrospective Studies
Safety
Social isolation
Sociology
Studies
Young Adult
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Description
Summary:This study examined the impact of eliminating intramuscular PRN medication for agitation on patient and staff safety in an acute psychiatric inpatient setting. The current retrospective chart review investigated the use of PRN medications (oral and intramuscular) to treat acute agitation, including aggression, and related outcomes before and after a mandated change in PRN practice that required real time physician input before administration of intramuscular medications. The use of both oral and intramuscular PRN medications dramatically decreased following implementation of the mandated change in practice. In particular, the use of intramuscular PRNs for agitation decreased by about half. Despite this decrease, the assault rate in the hospital was unchanged, and the utilization of restraint and seclusion continued to decrease. It is possible to reduce the utilization of PRN medications for agitation without broadly compromising safety on acute care psychiatric inpatient units.
ISSN:0033-2720
1573-6709
DOI:10.1007/s11126-015-9359-1