RE: Antipsychotic Med Policy

[Polivka, Paula]

I have had similar issues with anti psychotics and appropriate diagnoses.   Even "other organic psychotic conditions-chronic" trigger on my QI's as low risk for antipsychotic treatment without the appropriate DX.   You have to be able to code for hallucinations present to not trigger the low risk QI. But if the symptoms are controlled and not present or not documented when you are doing the quarterly /annual MDS, you can't code for them.  Feels like a catch 22.   Any other suggestions are welcome.     Paula Polivka, RN, BSN, DNS [EMAIL PROTECTED] Confidentiality Statement: This message is intended for the sole use of the individual and entity to whom it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the intended addressee, nor authorized to receive for the intended addressee, you are hereby notified that you may not use, copy, disclose or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete the message. Thank you. -----Original Message----- From: Holly Sox, RN, RAC-C [mailto:[EMAIL PROTECTED] Sent: Tuesday, December 16, 2003 1:32 PM To: [EMAIL PROTECTED] Subject: Antipsychotic Med Policy Hi, Group, One citation we received on Survey was for antipsychotic use without the appropriate dx. I have really been tearing my hair out with psychotropic meds in general since starting here a year ago.  I have developed a letter to send to MD when antipsychotic is initiated without the proper dx as well as when I find one already on the med without dx.  I suggested implementing a policy of not starting antipsychotic med until the form was completed by the physician, but DON and Administrator both said they felt uncomfortable with a policy of not following a physician's order.   But, is that any different from not following any other inappropriate order without clarification??? For example, I wouldn't start IVF at 300 cc/hour on a CHF patient, just because the doctor ordered it.   Could any of you who are "lurking" surveyors (Yeah, you, MR), send me some guidance (along with links to supporting regulations, etc)?  Also, what are other facilities doing as far as P/P for antipsychotic meds? Thanks! Holly  Holly F. Sox, RN, RAC-C Clinical Editor   www.careplans.com   [EMAIL PROTECTED]