Lack of Non-Pharmacological Interventions for Psychotropic Medication Use
Penalty
Summary
The facility failed to ensure that non-pharmacological interventions were implemented for the management of psychotropic medications for two residents. Review of the facility's policy indicated that non-pharmacological approaches should be used to minimize the need for psychotropic medications, permit the lowest possible dose, and allow for discontinuation when possible. However, for one resident with dementia and another with major depressive disorder and Alzheimer's disease, physician orders included quetiapine, an antipsychotic medication, without documentation of non-pharmacological interventions related to its use. Interviews with the Resident Care Manager and the Director of Nursing confirmed that non-pharmacological interventions were expected to be in place when residents were started on psychotropic medications. Joint record reviews for both residents showed that such interventions were not documented in the physician's orders, despite the facility's policy and staff expectations.