Psychotropic PRN: a model for best practice management of acute psychotic behavioural disturbance in inpatient psychiatric settings.

PRN, or 'as needed', medications are administered frequently by mental health nurses in psychiatric inpatient settings to manage difficult and disturbed behaviour when other strategies fail. Research indicates that approximately 50% of psychiatric inpatients receive a PRN medication at some stage of their treatment. Although evidence indicates that traditional antipsychotics and benzodiazepines are equally effective in managing acute agitation and other psychotic symptoms, it has been recommended that benzodiazepines should be the first-line of action because they do not cause the serious side-effects that are common with the traditional antipsychotics. Unfortunately, research indicates that doctors and nurses are not taking advantage of the latest evidence to guide their practice. This paper reviews the limited research available in the area and makes recommendations for evidence-based practice.