Failure to Identify and Respond to EPS in Resident on Antipsychotic Medication
Penalty
Summary
The facility failed to identify and respond to adverse effects of psychotropic medication in one resident who was administered Risperdal, an antipsychotic medication. The resident, who had diagnoses including schizophrenia and depression, was observed on two separate occasions exhibiting a facial chewing motion while in the dining room. Despite these visible symptoms, the resident's medical record indicated that EPS (extrapyramidal symptoms) monitoring was documented as negative for all shifts during the same period, and an AIMS assessment earlier in the month also reported no abnormal involuntary movements. Interviews with the assigned CNA and LVN confirmed that both observed the facial chewing motion but were unaware that it was a sign of EPS. The DON also observed the symptom and identified it as EPS, stating that nursing staff should have been able to assess these signs and symptoms. The facility's policy required documentation of adverse reactions and monitoring for psychotropic drug complications, but this was not effectively implemented for this resident.