Failure to Limit PRN Antipsychotic Medications to 14 Days
Penalty
Summary
The facility failed to ensure that as needed (PRN) psychotropic medications, specifically antipsychotics, were limited to a 14-day duration unless a medical provider documented a rationale for continued use. For one resident with vascular dementia and delusional disorders, an order for PRN olanzapine did not specify a 14-day limit, and subsequent medication regimen reviews did not address the need to monitor or discontinue the medication after 14 days. The medication remained active beyond the allowed period without appropriate documentation or evaluation by a provider. Similarly, another resident with severe dementia and behavioral disturbances had a PRN order for quetiapine fumarate that also lacked the required 14-day limitation. The medication regimen review process did not identify or address the ongoing use of the PRN antipsychotic within the required timeframe. Staff interviews revealed a lack of understanding regarding the review process for PRN antipsychotic medications, and facility policy required PRN antipsychotic orders to be limited to 14 days, with a new evaluation needed for continued use.