Failure to Monitor Target Behaviors for Residents on Antipsychotic Medications
Penalty
Summary
The facility failed to identify and monitor target behaviors for two residents who were prescribed antipsychotic medications. For one resident with vascular dementia, major depressive disorder, and anxiety, the care plan included monitoring target behaviors and gradual dose reduction as ordered. Despite multiple physician orders for antipsychotic medications and care plan interventions, there was no documentation that the specific target behavior of yelling out was monitored every shift as required by facility policy. The Director of Nursing Services (DNS) confirmed that behavior monitoring should have been documented electronically but was unable to provide evidence that this was done. For another resident with bipolar disorder, anxiety disorder, and mood disorder, physician orders required behavior monitoring every shift for specific target behaviors while receiving Quetiapine. Although behavior monitoring was completed prior to a certain date, after the resident was re-admitted and continued on Quetiapine, the order for behavior monitoring was missed and not completed as required. The DNS acknowledged that the responsibility for ensuring behavior monitoring fell to the admitting nurse and that the monitoring had not been done. Facility policies directed that residents on antipsychotic medications must have specific target behaviors identified and monitored every shift, but this was not followed for these residents.