Exploring Acute Care Nurses' Decision-Making in Psychotropic PRN Use in Hospitalized People with Dementia

• Author / Creator

  Walsh, Brittany

• This qualitative descriptive study used semi-structured interviews to explore how acute care nurses decide to administer “as needed” (PRN) psychotropic medication to hospitalized people with dementia. Eight nurses from three acute care units in a large tertiary hospital in Western Canada were interviewed using a semi-structured interview guide. Conventional content analysis yielded three themes that reflect nurses’ decision-making related to administering PRNs to hospitalized people with dementia: Legitimizing Control which involved medicating undesirable behaviors to promote the nurses’ perceptions of safety; Making the Patient Fit to maintain routine and order; and Future Telling involved pre-emptively medicating to prevent undesirable behaviors from escalating. Nurses provided little to no mention of assessing for physical causes contributing to behaviors; notably, not one participant mentioned pain. PRNs were seen as a reasonable alternative to physical restraints and were frequently used. Additionally, organizational and unit routines greatly influenced nurses’ decision-making. These findings provide an initial understanding into some of the ways nurses make decisions to administer PRN medications and may inform prescribing practices. More research is needed to better understand the complexities of nurses’ decision-making which will assist in the development of interventions for nursing practice.

• Subjects / Keywords

  • PRN
  • dementia
  • qualitative
  • psychotropic
  • decision-making
  • nurse

• Graduation date

  Spring 2020

• Type of Item

  Thesis

• Degree

  Master of Nursing

• DOI

  https://doi.org/10.7939/r3-ce89-xh34

• License

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