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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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PRN Medication Management Policy

1. Purpose: This policy ensures that PRN (as-needed) medication is managed safely and effectively at {{org_field_name}}, in compliance with CQC Fundamental Standards, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, NICE Guidelines, and the Medicines Act 1968. It aims to ensure that PRN medication is administered appropriately, recorded accurately, and reviewed regularly to support the well-being of people we support.

2. Scope: This policy applies to all staff involved in the prescribing, administration, storage, documentation, and review of PRN medication at {{org_field_name}}. It ensures that PRN medication is used appropriately and in a way that maximises its therapeutic benefits while minimising risks, including overuse or underuse.

3. Related Policies:

• Medication Management and Administration Policy (CH21)
• Safe Care and Treatment Policy (CH11)
• Risk Management and Assessment Policy (CH18)
• Person-Centred Care Policy (CH07)
• Mental Capacity and Deprivation of Liberty Safeguards Policy (CH39)

4. Policy Statement: {{org_field_name}} is committed to ensuring that PRN medication is used in a way that is:

• Clinically appropriate: Only administered when necessary based on assessed needs.
• Person-centred: Based on individual care plans and preferences.
• Legally compliant: Adhering to national legislation and regulatory standards.
• Well-documented: With clear recording and audit trails to prevent misuse.
• Regularly reviewed: To ensure effectiveness and appropriateness.

5. PRN Medication Assessment and Authorisation:

• PRN medication must be prescribed by a qualified healthcare professional and recorded in the individual’s Medication Administration Record (MAR).
• A detailed PRN protocol must be developed, including:
  • Indications for use (specific symptoms or conditions it treats).
  • Minimum time intervals between doses.
  • Maximum daily dosage.
  • Monitoring requirements (side effects, effectiveness).
  • Alternative strategies before administration.

6. Administration of PRN Medication:

• PRN medication must only be administered by trained staff who have completed medication administration training.
• Before administration, staff must:
  • Confirm the need for the medication by assessing symptoms.
  • Check the individual’s MAR chart and PRN protocol.
  • Gain verbal consent where possible and respect individual preferences.
  • Ensure correct dosage and administration route.
  • Record the administration in the MAR chart and daily notes.
  • Monitor and document the effectiveness of the medication.

7. Record Keeping and Documentation:

• Each PRN administration must be recorded in the MAR chart, including:
  • Time and date of administration.
  • Dosage and route given.
  • Reason for administration.
  • Outcome and effectiveness of the medication.
• If PRN medication is not administered despite being prescribed, a clear record must be made, including the reason (e.g., refusal, alternative interventions used).
• Regular audits must be conducted to ensure compliance with documentation standards.

8. Storage and Security of PRN Medication:

• PRN medications must be stored securely in a locked medication cupboard in line with the Medication Management Policy (CH21).
• Controlled drugs (CDs) prescribed as PRN must be stored in the CD cabinet and recorded in the CD register.
• Expiry dates must be monitored, and expired medication must be disposed of safely following pharmacy guidelines.

9. Review and Monitoring of PRN Medication:

• PRN medication must be reviewed regularly, including:
  • Weekly monitoring by staff for usage trends.
  • Monthly medication reviews with the GP or prescribing healthcare professional.
  • Annual full medication review as part of care planning.
• If PRN medication is used frequently, a care plan review must be conducted to assess whether regular medication or alternative treatment is required.

10. PRN Medication for Individuals with Limited or No Capacity:

• Where an individual lacks capacity to request PRN medication, the decision must be based on:
  • Observed symptoms.
  • Best-interest decisions in line with the Mental Capacity Act 2005.
  • Consultation with healthcare professionals, family members, or advocates.
• A Deprivation of Liberty Safeguards (DoLS) authorisation may be required for specific PRN medications affecting mental capacity or behaviour.

11. PRN Medication and Behavioural Management:

• PRN medication must not be used as a routine method of managing behaviours that challenge.
• Non-medication strategies (e.g., de-escalation techniques, distraction, environmental adjustments) must be attempted first.
• PRN medication for behavioural support must:
  • Have a clear protocol agreed with the GP or psychiatrist.
  • Be time-limited and subject to frequent review.
  • Be documented with specific reasons for use and effectiveness assessment.

12. Staff Training and Competency Assessment:

• All staff administering PRN medication must complete medication management training.
• Additional PRN-specific training is required for medications with complex administration requirements (e.g., pain relief, sedatives, anti-anxiety medication).
• Staff competency is assessed annually through medication audits and direct observation.

13. Handling PRN Medication Errors:

• Any errors in PRN medication administration (e.g., wrong dosage, missed dose, incorrect recording) must be reported immediately following the Incident Management Policy.
• Affected individuals must be monitored for adverse effects.
• A root cause analysis must be conducted to prevent recurrence.

14. Family and Advocate Involvement:

• Families and advocates must be informed of PRN protocols, especially for individuals who require assistance in decision-making.
• Family members’ concerns regarding PRN medication use must be recorded and addressed in care plan reviews.

15. Policy Review: This policy will be reviewed annually or sooner if CQC guidance, legislative updates, or operational needs require an update.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.