Failure to Attempt Non-Pharmacological Interventions Before PRN Medication
Penalty
Summary
The facility failed to provide evidence that non-pharmacological interventions were attempted prior to administering PRN psychotropic medication to a resident. The facility's policy on Behavioral Assessment, Intervention, and Monitoring mandates the use of non-pharmacological approaches to manage behavioral symptoms before resorting to antipsychotic medications. However, for a resident with diagnoses including COPD, anxiety, and depression, there was no documentation of such interventions being attempted before administering Lorazepam, an anti-anxiety medication, on multiple occasions. The resident's clinical records showed repeated use of PRN Lorazepam in November and December 2024, with no evidence of non-pharmacological interventions being tried first. The Director of Nursing confirmed the absence of documentation for these interventions prior to the administration of the medication. This deficiency was identified during a review of the facility's policy, clinical records, and staff interviews.
Plan Of Correction
1. Facility assessed resident 24 and no ill side effects noted. 2. Facility will review all residents with PRN psychotropic medication orders to ensure orders contain directions for non-pharmacological approaches are in place by 2-10-25. 3. Education will be provided to nursing staff regarding attempting and charting non-pharmacological approaches prior to giving any PRN psychotropic medication by 2-10-25. 4. Audits will be completed by the Director of Nursing or designee on all PRN psychotropic meds given weekly for 4 weeks to ensure that non-pharmacological approaches are attempted and documented prior to medication being given. After audits are complete, charting will be reviewed with the morning meeting for ongoing compliance. 5. Process will be monitored in the Quality Assurance and Improvement meeting to ensure this process is sustained.