Failure to Obtain and Renew Informed Consent for Psychotropic Medications
Penalty
Summary
The facility failed to obtain informed consent for the use of psychotropic medications for two residents. For one resident with diagnoses including schizophrenia and major depressive disorder, the clinical record showed that Chlorpromazine, an antipsychotic medication, was prescribed and administered via gastrostomy tube for hiccups. However, there was no documentation that the resident received education regarding the risks and benefits of Chlorpromazine prior to its initiation. The Director of Nursing confirmed that informed consent was not obtained for this medication, despite its classification as a psychotropic drug. For another resident with diagnoses including schizophrenia and metabolic encephalopathy, the facility did not ensure that informed consent for the use of Risperidone and Seroquel, both antipsychotic medications, was renewed every six months as required. The resident's cognition was intact, and the medications were prescribed for symptoms such as verbal aggression, angry outbursts, and auditory hallucinations. Review of the medical record revealed that the most recent informed consent form for these medications was outdated and had not been renewed within the required timeframe. A registered nurse acknowledged that the consents should have been updated to ensure the resident remained informed about the continued use, risks, and benefits of the medications. The facility's failure to obtain and renew informed consent for psychotropic medications was contrary to both state regulatory requirements and the facility's own policy. The deficiency was identified through interviews, record reviews, and reference to relevant All Facilities Letters and facility policies, which specify the need for written informed consent and regular renewal for psychotherapeutic drug use.