Why is your patient sedated?

Area of Science:

• Pharmacology
• Clinical Pharmacy
• Patient Safety

Background:

• Sedative-hypnotic (SH) medications are frequently prescribed to hospital inpatients.
• Ensuring appropriate use requires clear documentation of clinical indications.

Purpose of the Study:

• To evaluate the documentation of clinical indications for prescribed sedative-hypnotic (SH) medications.
• To assess prescribing practices in a large, acute tertiary referral hospital.

Main Methods:

• An audit of 367 inpatient medication records for SH medications.
• Review of medical and nursing notes to identify documented indications.

Main Results:

• SH medications were prescribed to 42.5% of inpatients.
• Clinical indications were documented for only 24.4% of patients receiving SH medications.
• Nurses prescribed most SH medications (74%), and documentation rates were low, particularly for elderly, less mobile patients (47% indication documented).

Conclusions:

• Significant shortcomings exist in documenting the clinical rationale for SH medication use.
• Healthcare professionals, especially physicians, must improve justification of SH prescriptions in medical records.
• Clear guidance is needed for high-risk patient groups to ensure safe and appropriate SH medication use.