Failure to Review and Update PRN Psychotropic Medication Orders Every 14 Days
Penalty
Summary
The facility failed to ensure that an as needed (PRN) psychotropic medication, specifically an antianxiety medication, was reviewed and updated every 14 days for a resident with severe cognitive impairment. The resident was admitted with an order for an antianxiety medication to be administered as needed for anxiety. Documentation showed that the medication was started and continued for several months, with a pharmacy medication regimen review recommending continuation past 14 days due to the resident's anxiety. However, a subsequent medication review did not indicate whether the medication should be continued and lacked signatures from the attending physician or the Director of Nursing (DON). Interviews with facility staff revealed a lack of awareness regarding the requirement to review and rewrite PRN psychotropic medication orders every 14 days. The Nurse Practitioner acknowledged the need for 14-day reviews, while the DON and an LPN were unsure of the renewal schedule. The Medical Director also indicated he was not aware of the 14-day review requirement for PRN medications and did not change the orders during his reviews. This lack of consistent review and documentation led to the deficiency identified during the survey.