- Mya Ackerman
- Summer 2026
Faculty instructor: Annette Jenkins
Abstract
Background
Medication administration errors involving pro re nata or PRN medications remain a significant patient safety concern in acute care settings. Nurses are responsible for determining whether PRN medications meet ordered administration criteria, including appropriate timing between doses. Existing electronic medication records (MAR) often require nurses to manually calculate the next available dose time, increasing cognitive workload and the potential for error.
Purpose
The purpose of the project is to address the risk of PRN medication timing errors by proposing the implementation of an automated next dose availability display within the MAR. This is a feature that is offered and can be added to the MAR in EPIC. By clearly displaying the earliest time a PRN medication may be safely administered, this intervention aims to improve patient safety, increase nursing efficiency, and reduce medication administration errors.
Methods
A review of current literature was conducted to examine medication safety practices, rates of medication errors, nursing workload and fatigue, and electronic health record interventions that support safe medication administration. Informal stakeholder feedback was obtained from bedside nurses regarding the challenges of calculating PRN medication availability times and the perceived usefulness of an automated display feature. Additionally, current MAR workflows were evaluated to identify opportunities for integration of the proposed intervention.
Discussion
Implementing an automated PRN next dose availability display has the potential to provide nurses with real-time decision support, improve medication administration accuracy, and enhance patient outcomes. Future steps include collaboration with informatics specialists and organizational leadership to evaluate feasibility, develop implementation protocols, provide staff education, and assess the intervention’s impact on medication safety through quality improvement initiatives.