Re: Antipsychotic Med Policy

[nursejane]

Hi Holly, In our facility we have a strict policy that before the physician is contacted there must be documentation in the nurses notes and on a behavior log to support the need for the med.(In the case of an emergency, danger to resident, staff or others, we accept a one time or PRN order only and it must be followed up immediately.)    Unit manager must be notified immediately, behavior management team must meet, and any recommendation for an antipsychotic, psychotropic, etc, anti-anxiety must be made via the behavior mgmt team.    Nurses have to start a form  at onset of behavior, that rules out any s/s of infection, vital signs, treat for pain, obtain UA, etc before anyone picks up a phone. Whoever gets the order has to write on the order, med, dose, frequency, and diagnosis (nursing or doctor's.) You have the right to not give the med without a reason.    By the way, our policy was developed after a long talk with surveyors when we were cited a few years ago. Haven't had a problem since, IF the nurses follow the policy.  It has been MY experience that if you ask a surveyor, and don't confront them, they will assist you, give you ideas, etc.   Good luck. If you need any help feel free to contact me at [EMAIL PROTECTED]   Jane Barbour LPN RAC-C Assessment Coordinator  ----- Original Message ----- From: Holly Sox, RN, RAC-C To: [EMAIL PROTECTED] Sent: Tuesday, December 16, 2003 1:32 PM 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]