PRN Psych medications

[babaloo, BSN]

If a patient is undergoing a crisis, upon trying other less restrictive measures and failing, and upon offering the patient his/her PRN medications (for ex. Ativan), however the patient refuses the medication as well and is still displaying violent behavior, can you administer the PRN medications anyways even without the consent of the patient in order to maintain patient safety?

[kennybania]

At the facility I work at, we can administer PRN IM medication if the patient refuses PO against their will if they are a danger to themselves or a danger to others. If this results in the patient being held for the IM, it is considered a medication hold and we have to do restraint paperwork. But an IM medication is considered a less restrictive measure than seclusion or a restraint bed, so it is often used against the patient's will before these measures are needed if they are indeed violent and combative.

[Mandychelle79, ASN, RN]

We are allowed in my facility. I commonly get orders for po/im. 7/10 times I can talk the pt into taking the po. I offer them a choice, basically saying you are going to be taking this medication, it's up to you if you take this pill for me or if we have to call security to help give you a shot.

[loriangel14, RN]

It likely would depend on your policy. Where I work if they won't take meds po then they are restrained and given them IM.

[Meriwhen, ASN, BSN, MSN, RN]

If they meet criteria for being a danger to themselves and/or others, yes, you can medicate them IM against their will.

[JuliRN]

If a patient is out of control and presents as a danger to self, staff, or other patients then we can administer an IM (after notifying MD that the pt. is refusing PO). The downside to this is the huge amount of paperwork we have to do since this is considered a chemical restraint. It's really beneficial to build a good rapport with your pt. as this will make them (in some cases) less leery in taking a po prn.