Failure to Limit PRN Psychotropic Medication Use
Penalty
Summary
A deficiency occurred when a resident with a diagnosis of generalized anxiety disorder was prescribed and administered Ativan, an antianxiety medication, on an as-needed (PRN) basis prior to medical appointments. The facility's policy requires that PRN psychotropic medications be limited to 14 days unless the physician documents a rationale for extending the order, including the duration. However, the medical record for this resident did not indicate that a 14-day stop date was initiated for the PRN Ativan, nor was there documentation from the physician to justify extending the PRN order beyond 14 days. Record review confirmed that the resident received Ativan as needed, and interviews with nursing staff and the Director of Nursing verified that the required 14-day stop date and physician re-evaluation were not in place. The failure to follow facility policy regarding the use of PRN psychotropic medications resulted in the resident not being free from unnecessary psychotropic medication use.