Community Mental Health Journal

, Volume 44, Issue 4, pp 261–270

Psychiatric Use of Unscheduled Medications in the Pennsylvania State Hospital System: Effects of Discontinuing the Use of P.R.N. Orders

Authors

    • Allentown State Hospital
    • Office of Mental Health & Substance Abuse Services
  • Robert H. Davis
    • Office of Mental Health & Substance Abuse Services
  • Aidan Altenor
    • Office of Mental Health & Substance Abuse Services
  • Dung P. Tran
    • Allentown State Hospital
    • Office of Mental Health & Substance Abuse Services
  • Karen L. Wolfe
    • Allentown State Hospital
    • Office of Mental Health & Substance Abuse Services
  • John A. Deegan
    • Office of Mental Health & Substance Abuse Services
    • Wernersville State Hospital
  • Jessica Bradley
    • Office of Mental Health & Substance Abuse Services
Original Paper

DOI: 10.1007/s10597-008-9126-y

Cite this article as:
Smith, G.M., Davis, R.H., Altenor, A. et al. Community Ment Health J (2008) 44: 261. doi:10.1007/s10597-008-9126-y

Abstract

The objective of this prospective study was to assess patient exposure to the psychiatric use of unscheduled medications at all nine Pennsylvania state hospitals and to unify practice guidelines in this regard. In August 2004, a decision was made to discontinue the use of p.r.n. orders for psychiatric indications. All unscheduled medications, (p.r.n. and STAT physician’s order) administered for psychiatric indications were entered into a uniform database. A total of 46,913 unscheduled medications were administered to people served in the hospital system throughout this 15 month study. During March 2004, 87.7 unscheduled medications per 1,000 days-of-care were administered in the hospital system. During the last month of this study, May 2005, this rate had decreased to 17 per 1,000 days-of-care. Many hospital safety measures significantly improved as a result of this change. Cessation of p.r.n. medication use for psychiatric indications has significantly decreased patient exposure to unnecessary psychotropic medications and has resulted in a safer hospital system.

Keywords

MedicationHospitalPracticePRNRestraint

Copyright information

© Springer Science+Business Media, LLC 2008