When-required medicines, side effects and changes in condition

When-required medicines, sometimes called PRN medicines, must not be given casually. Staff should know what the medicine is for, the signs or symptoms that justify it, the correct dose, the minimum interval between doses, any 24-hour maximum, and when to seek further clinical advice.

Staff must observe for side effects and changes in condition. A child who becomes unusually drowsy, agitated, confused, sick, develops a rash, has breathing difficulties or becomes suddenly unwell after a medicine needs prompt review. Administration does not end care - ongoing observation and response are essential.

What safer PRN practice includes

• Check the reason: confirm why the PRN medicine is needed now.
• Check timing and maximum dose: do not rely on memory.
• Record why it was given: document the clinical reason, not just the time.
• Review the effect: record whether it helped and whether further action is needed.
• Escalate patterns: frequent PRN use should trigger a review of the child's plan.

PRN medicines should answer a clear need, not fill a routine gap in the shift.