Failure to Discontinue PRN Psychotropic Medication After 14 Days
Penalty
Summary
The facility failed to ensure that a resident was free from chemical restraints that were not required to treat medical symptoms. Specifically, a male resident with a history of nontraumatic intracerebral hemorrhage, quadriplegia, and restlessness/agitation was prescribed Xanax 0.5mg as a PRN antianxiety medication. The physician's order for Xanax did not specify an end date, and the medication was administered on multiple occasions over a period exceeding 14 days. There was no documented rationale for the continued provision of the medication beyond the 14-day period. The resident's care plan indicated the use of antianxiety medication for anxiety disorder, with goals to avoid discomfort or adverse reactions. However, the facility did not discontinue the PRN prescription after 14 days as required, nor did it document a justification for ongoing use. During an interview, the DON acknowledged the expectation that PRN psychotropic medications should not be prescribed for more than 14 days and was unable to explain why the order remained active. Additionally, the facility did not have a written policy regarding PRN antianxiety/psychotropic medication use.