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.