Failure to Obtain Timely Informed Consent for Psychotropic Medications
Penalty
Summary
The facility failed to obtain signed written consent for the administration of psychotropic medications for two residents who were alert, oriented, and able to make their own health care decisions. According to the facility's policy, staff and physicians are required to review non-pharmacological alternatives, indications and rationale for the medication, potential risks and benefits, and the resident's right to accept or decline treatment prior to obtaining documented consent. However, for both residents, psychotropic medications were administered for several days before the consent forms were signed. One resident with schizoaffective disorder and a history of falls was admitted and began receiving aripiprazole and olanzapine as ordered by the physician, but did not have a signed consent form until six days after starting the medications. Another resident with bipolar disorder and a recent femur fracture was administered fluoxetine and quetiapine, but the consent form was not signed until four days after medication administration began. Interviews with facility staff, including the unit manager, ADON, and DON, confirmed that it is the responsibility of the admitting nurse to obtain informed consent prior to administering psychotropic medications, and that this was not done in these cases.