Psychotropic medications require diagnosis, indication, monitoring for effectiveness, monitoring for adverse effects, behavioral interventions when appropriate, and physician/pharmacy review. CMS guidance states that residents using psychotropic drugs should receive gradual dose reductions and behavioral interventions unless clinically contraindicated, and PRN psychotropic orders have time limitations and documentation requirements.
Nurse Responsibilities
- Document target behavior or symptom.
- Use non-pharmacologic interventions when appropriate.
- Monitor sedation, falls, confusion, EPS, appetite change, mood change, sleep change, and behavior response.
- Document PRN medication reason, intervention attempted, effect, and follow-up.
- Communicate concerns to provider, pharmacist, and IDT.