Abstract
Prescription and administration of pro re nata (PRN) medications has remained a poorly discussed area of the international literature regarding ethical tenets influencing this type of medication practice. In this commentary, ethical tenets of PRN medicines management from the clinical perspective based on available international literature and published research have been discussed. Three categories were developed by the authors for summarising review findings as follows: ‘benefiting the patient’, ‘making well-informed decision’, and ‘follow up assessment’ as pre-intervention, through-intervention, and post-intervention aspects, respectively. PRN medicines management is mainly intertwined with the ethical tenets of beneficence, nonmaleficence, dignity, autonomy, justice, informed consent, and error disclosure. It is a dynamic process and needs close collaboration between healthcare professionals especially nurses and patients to prevent unethical practice.
Highlights
Medicines management is a complex process and has a multidisciplinary identity indicating the need for close collaboration between healthcare professionals including physicians, pharmacists, nurses, and patients [1]
pro re nata (PRN) medicines management provides a flexible care condition for the patient to submit the medication request to the nurse with the aim of relieving his/her physical and psychological suffering who has the legal and ethical responsibility to decide on the appropriateness of pharmacological interventions based on the physician order [22,23]
Discussion regarding the ethical tenets of PRN medicines management can shape the fundamental principles of law, indicating what is permissible to practice legally and what must be done to ensure the safety of medicines management [28]
Summary
Medicines management is a complex process and has a multidisciplinary identity indicating the need for close collaboration between healthcare professionals including physicians, pharmacists, nurses, and patients [1]. The main tool for an effective collaboration is interaction between healthcare providers that can reduce adverse drug events given the significance of communication lines in the prevention of medications errors [2]. Incorrect interpretation of orders, and inappropriate monitoring of medications reflect insufficient and ineffective multidisciplinary collaboration between healthcare professionals involved in the medication process that perpetuates medication errors [3,4]. The best outcome of the medication process is achieved when pharmacists, physicians and nurses undertake their assigned roles and collaborate to ensure clinical medication safety [8,9]
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