What is the potential consequence of not documenting the administration of a PRN medication?

Not documenting the administration of a PRN (as-needed) medication can lead to a significant failure to monitor the effects and outcomes of the medication. Documentation serves as a critical part of patient care, ensuring that all healthcare providers are aware of what medications have been administered and when. Without accurate records, it becomes challenging to assess the medication's effectiveness, identify potential side effects, or evaluate the resident's response to treatment over time.

Monitoring the effects of medication is essential in determining if the treatment is appropriate for the resident's condition. This oversight can also hinder communication among caregivers, leading to inconsistent care and potential health risks if subsequent doses are needed but not tracked properly. In assisted living, where residents often have complex health needs, such documentation is crucial for maintaining their safety and well-being.