Unjustified PRN Antipsychotic Use Without Proper Diagnosis
Penalty
Summary
A deficiency was identified when a resident was administered haloperidol, an antipsychotic medication, on an as-needed (prn) basis for anxiety manifested by agitation, without a specific diagnosis or documented justification for its use. The resident's medical record indicated diagnoses of depression and vascular dementia, with severe cognitive impairment and total dependence on staff for daily activities. The physician's order for haloperidol did not include a qualifying mental health diagnosis, and staff interviews confirmed there was no appropriate indication for antipsychotic use as required by facility policy. Further review revealed that the facility's policy prohibits the use of antipsychotic medications on a prn basis and restricts their use to specific mental health conditions or certain physical behavior problems. Both the RN and DON acknowledged that the order for haloperidol did not meet these criteria, and the medication should not have been administered without a proper diagnosis or indication. The lack of adherence to policy and regulatory requirements resulted in the potential for unnecessary medication use for the resident.