PRN Psychotropic Medication Order Exceeded 14-Day Limit Without Rationale
Penalty
Summary
The facility failed to ensure that as-needed (PRN) psychotropic medication orders were limited to 14 days, as required by policy, for one resident. A review of the medical record for a resident with diagnoses including bipolar disorder, schizoaffective disorder, restlessness, and agitation showed a physician's order for Hydroxyzine 25 mg by mouth every eight hours as needed for anxiety, without a stop date. The medication was administered on two occasions, and the resident's care plan included monitoring for side effects and effectiveness of psychotropic medications. The facility's policy required that continuation of PRN psychotropic medications beyond 14 days must be accompanied by practitioner documentation of the rationale, which was not present in this case. An interview with the RN/Regional Director of Clinical Services confirmed the absence of a stop date and acknowledged the requirement for a 14-day limit on PRN psychotropic medications.