PRN Psychotropic Medication Order Lacked Required 14-Day Stop Date
Penalty
Summary
The facility failed to ensure compliance with its policy regarding the use of PRN (as needed) psychotropic medications. Specifically, a review of clinical physician orders for a resident with diagnoses including malignant neoplasm of the prostate, secondary malignant neoplasm of bone, and adult failure to thrive revealed an order for PRN Lorazepam with an indefinite end date. According to the facility's policy, PRN orders for psychotropic drugs must be limited to a 14-day duration unless the prescribing practitioner documents a rationale for extending the order and specifies the duration in the resident's medical record. During an interview, the Director of Nursing confirmed that the PRN Ativan order did not have the required stop date. This deficiency was identified through record review and affected one of three residents reviewed for unnecessary medication use, in a facility with a census of 85 residents.