How soon to give a prn??

[candycane267]

i had to post on this because i questioned how early do you give a prn. my assistant nurse manager on nights said 30 minutes prior - is acceptable. because we do computerized meds (we scan them). i gave a prn med 6 minutes early and the hand held was asking why - so i usually put in patients request. but my anm said she always puts in nursing judgement.

:w00t:

[WSU_Ally_RN, BSN, RN]

PRN meds I never give early. If I give them early all day, and so does the next shift, the patient has the potential to get a whole extra dose. I don't want to be the one to give that extra, not ordered, dose.

[leslie :-D]

unless i have a specific md order, i do not believe there is any wiggle room w/prn's.

i never give them early.

if i find they need to be given earlier, even as little as half hour, i get the order changed.

leslie

[RNgonewild]

I do up to half hour early, but I try to hold them to 15 minutes before. I just let them know approximately when the next dose is due and to call me to remind me. A medicated patient is a happy patient!:redpinkhe

[pattycakeRN]

And so the overmedicated pt can become the hypoxic patient... I never give PRNs early. I think it looks bad, and if the pt needs it earlier- that means it's time for me to reevaluate the pain/nausea/whatever situation and call the doc.

All this IMHO...

[AprilRNhere]

I will give it half an hour early...but only after looking back at the previous 24-48 hours. If it's a pattern, I will have a discussion with the pt about how well the meds work, for how long, and either discuss with the dr...or leave a note for him/her in the morning.

I thought there was no wiggle room with prn's, but as a new nurse, in orientation was told by multiple preceptors that the hafl hour rule still applied as long as I looked back at total use for the day.

[twarlik]

I'll give PRN about 30 minutes early if needed. However, with pain meds I try to see if the patient's pain is really being controlled. If a pt is consistently needing pain meds early, then I'm on the phone to the doc to see if a change can be made.

[lpnstudentin2010, LPN]

A medicated patient is a happy patient!:redpinkhe

A bit off topic but as a patient I TOTALLY 100% agree with this statement.

[xviii-xxv]

i think give it after u check the chart for DO or when was the last med given...and if the situation really needs the med based on the pts need and RN's judgement..

[GrumpyRN63, ADN, RN]

Narcs I will not give earlier than 10 minutes before due, if it's q 3hrs and they need something 1/2hr ahead, consistently, dose/drug/interval/addition of adjunt meds ie NSAIDS, etc. need to be addressed- I am a firm believer in the power of pharm aceuticals !! no need NOT to have decent pain control, if it's (clearly) drug seeking,they wait to the minute, I wont be manipulated

[nyapa, RN]

We have both computerised systems and paper medication charts, depending on which medical / surgical team the patient is under, as well as the ward they are on - ie the nursing staff may not have been orientated to it yet.

We cannot give prn medications early on the computerised system. It just will not allow it. But there is the option of giving nurse initiated medications, such as paracetamol (acetominaphen I think you call it there? Forgive my spelling), but it can only be done once before review.

On the papercharts, I usually won't do it until at least 15minutes beforehand. Because by the time I write it up in the ward drug register, and then on the patients chart, and then check it with another nurse at the patient's bedside, then it will be relatively close to the allotted time.

If the pain is not controlled before then, then the patient needs review, in fact deserves review. My registration is just as important...

[elizabells, BSN, RN]

Never more than 10 min early. I got called into the principal's office once just for giving q3 prns... q3h. Our unit doesn't look too kindly on adequate pain control as it stands, so I'm not about to mess around with giving them early.