Ask the Nursing Expert ... about physcotropic programs
Angel McGarrity-Davis, RN, CDONA, NHA
I have been assigned to put together a psychotropic program. Can you please help me?
This is a very important aspect of a unit manager's responsibilities. It pertains to F-tag 329 (Unnecessary Drugs), which has to do with evaluating the appropriate use of antipsychotic medications.
A few things you need to ensure that your nurses do:
• Evaluation — That assessment and underlying causes are identified for residents who display behaviors;
• Medical conditions are ruled out, and vital signs, lab results, drug side effects and recent changes in condition are taken into account;
• Staff describe in their documentation the resident's behavior, when it started, how long it lasted, possible precipitating events or environmental triggers, using individualized knowledge about the person;
• Did staff contact the attending practitioner immediately for a medical evaluation, as appropriate?
• Did they apply non-pharmacological interventions, when documenting the behaviors?
• Consider how the resident typically communicates needs such as pain, hunger, thirst or frustration;
• Did staff, in collaboration with the practitioner, identify risk and causal/contributing factors for behaviors and document them?
• Did staff make sure consent forms are appropriately filled out with the risks and benefits of the medication?
• If physician orders are given, ensure diagnosis specific for the symptoms the medication is being used to treat, specific behavior the physician is using to control and utilize lower dosing and/or AMDA's, geriatric dosing.
Remember: Focus on the resident and center care on him or her.