Lack of Physician Rationale for Extended PRN Psychotropic Medication Use
Penalty
Summary
The facility failed to provide a clinical rationale for the continued use of a PRN psychotropic medication beyond the 14-day limit for one resident. According to facility policy, PRN psychotropic medications should be limited to 14 days unless a longer duration is justified by the attending physician or prescribing practitioner. A resident with diagnoses including bipolar disorder, liver failure, difficulty eating, gall stones, and heart disease was prescribed Lorazepam every six hours as needed for 45 days. Review of the clinical record showed no documented physician rationale for extending the PRN order past 14 days. The care plan referenced the use of anti-anxiety medications and noted the PRN order for Lorazepam, but there was no supporting documentation for the extended duration. The Nursing Home Administrator confirmed the absence of a physician's rationale for the extended PRN order.