Nurses’ knowledge sources when making decisions involving pro re nata medication in sheltered housings for older people: A qualitative descriptive study

Abstract

Although pro re nata medications (PRNM) are widely used among older patients in long-term care, current knowledge about nurses’ PRNM management is scarce. The study aim was to describe which knowledge sources nurses working in sheltered housing for older people use when making decisions regarding PRNM. This was a qualitative interview study with registered nurses ( n = 4) and assistant nurses ( n = 4) working in sheltered housings in mid and eastern Norway. Data analysis was based on qualitative and abductive content analysis, where evidence-based practice (EBP) was used in the abduction. The COREQ checklist was followed. Several knowledge sources are used when making decisions regarding PRNM, that represent the four elements of EBP. ‘Practitioner experience and judgement’ was a prominent source of knowledge among the nurses, while ‘Evaluated external evidence’ was less emphasized in PRNM decision-making. The results support previous research on EBP in nursing, and bring new knowledge regarding PRNM in the context of sheltered housing. To achieve appropriate and safe management of PRNM, there is a need to support nurses’ decision-making process, e.g. through PRNM guidelines and systems for documentation and information exchange. EBP in PRNM decision processes should be given attention, utilizing all elements including ‘Evaluated external evidence’ as a knowledge source.