Physician Inaction on Pharmacist's Medication Review
Penalty
Summary
The attending physician failed to act upon pharmacist-identified irregularities in the medication regimen of a resident diagnosed with major depressive disorder and schizophrenia. The resident was prescribed Abilify, an antipsychotic medication, and the consultant pharmacist recommended a review for a gradual dose reduction. However, the attending physician did not document an appropriate response or provide justification for the continued use of Abilify in the resident's clinical record. Instead, the facility's consultant psychiatric CRNP responded to the pharmacy recommendation and signed off on it. An interview with the Director of Nursing confirmed that the attending physician did not provide the necessary documentation or justification for the medication regimen.
Plan Of Correction
Step 1 - Medical Director reviewed the pharmacy recommendations and noted the rational and justification for continued use of Abilify and reason for rejection of the GDR. Step 2 - Going forward when CRNP reviews and gives responses to pharmacy recommendations they will be reviewed and signed off by Medical Director. Step 3 - Education to CRNP's and medical director for need of review and signing off of pharmacy recommendations. Step 4 - Audits will be completed going forward of pharmacy recommendations to assure medical director signs off in agreement prior to adding to resident's chart. Monthly times 3. DON or designee. Step 5 - Results to QAPI monthly times 2.