behavior monitoring

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Specializes in dialysis, ltc adon.

can anyone tell me if you need to do a behavior monitoring on the drug ambien?

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Specializes in Gerontology, Med surg, Home Health.

No. It is an hypnotic used for insomnia which isn't a behavior.

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Specializes in trauma, ortho, burns, plastic surgery.

Two scenarios here:

1. If is PRN ....NO... patient asks for AS NEEDED. You don't need to monitor on MAR.

But even then you need to have nursing notes about effectivness of med. You gave to him with a goal.... was ok? OR not? Any ASE? What did you do if wasn't ok?

Asses...and ...Call the dr...

2. Is is routinely, YES, you need to monitor hours of sleep Qshift and eventually monitor also and ASE, call the dr and dr will adjust the dose of ambien acording with the number of hour of sleep/or insomnia per shift, or any other ASE noted.

A good nurse is MUST to provide all these inf for rutinely ambien to dr, if the policy and procedure of facility asks for...is not..... is their problem, lol..but you like a GOOD nurse need to fallow up with it in your nursing notes and call the DR is somenthing "unusual" seems to be....

(patient could not sleep after ambien, patien looks like having ASE on ambien, patient refuse ambien ), and let a note to your supervisor related it, annonce next shift.... WRITING!

Next day IDT need to fallow up with and take an action.

Much more, the nurses when they chart about the patient they MUST to write on nursing notes how many hours the patient sleep or not, if dose of ambien was effective or not and/or are present ASE/allergy manifested, and how patient looks like (arousable, slightly arousable, dizinees, drowsiness, sleepy,obnubilated...comatose..OMG, lol)

Be a good nurse even if your policy is not there...look at patient, and remeber the ASE of ambien.

Critical thinking... "day time drowsiness" is not ONLY because he/she could become "more acute sick", but could be also from a ASE of ambien or to a TOO high dose of... THINK!

Monitor, monitor, monitor and think, note, write and report to up levels your assesment , and note again!

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Specializes in Gerontology, Med surg, Home Health.

Insomnia is NOT a behavior and does not need to be documented as such. End of story.

PS. Ask your pharmacy consultant.

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Specializes in trauma, ortho, burns, plastic surgery.

Insomnia is not a behavior (may be she couldn't expain ok), but you need to monitor the number of sleep hours for people with ambien..ROUTINELY and ADSE.

Let's say that you have a patient with routinely 0.5 ambien at bed time, normal logical mind tell me to monitor hours of sleep to know if it is effective or not, and to monitor side effect also. What is happen if is too much for him or is is not well tolerared, or is not enough and he could not sleep or if is an addiction, or if he already took and many other meds that interact with ambien and he could not sleep.... or if he is dizzy and could fall down because US we overdrug him/her and we didn't monitor it???

If a patient is still on ambien and dosen't work and he could not sleep, or sleep bad...we need to document it.

You don't need to document LIKE BEHAVIOR, you need to document like HOURS OF SLEEP PER SHIFT and ASE thinking and calling the doctor!

If the policy and procedures don't tell you to do it, the first good lawyer hired by family, will have a perfect "money-maker" case proving that "the patient" was overseadated dizzy or neglected because someone gave him/her ambien each night/or not gave it, without any documentation of s/s monitoring or for what reason and how the patient reacted at!

And at ONE POINT, they could have RIGHT!

I keep my opinion... everything is happen for a reason and we like nurses we need to monitor, asses, reasses, and take an action based on fidings.

Any policy or procedure for any company will not keep you safe in the front of law if you keep to give each evening ambien to a patient that is drowsy all day long, and you didn't documented/monitor it and take actions.

Any policy and procedure for any company, will not keep you safe if you give 5 mg of ambien each night to a patinet that cmplain that he/she could not sleep and you didn't monitored it and take actions.

Is my opinion and i am stuck on it! Monitor!

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Specializes in Med Surg, Nursing Administration for SNF.

Here in FL we used to be required to monitor hypnotics on BMF's but not anymore. Not trying to be rude but I cant imagine adding yet more to my 11-7 nurses, asking them to monitor number of hrs slept! Yikes! But I do see the point of trying to monitor for sedation as it relates to falls.

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Specializes in LTC, Hospice, Case Management.
can anyone tell me if you need to do a behavior monitoring on the drug ambien?

Zuzi, you are stuck on the wrong question tho..

The question is - does ambien need BEHAVIOR monitoring and the answer to THAT question is... No as insominia is NOT behavior.

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It is my understanding that insomnia is not a behavior per se. However, according to a state surveyor who was recently in our meeting, she informed us that we must be documenting non-pharmacologic interventions (darkening room, adjusting get-up times, ear plugs, etc.) prior to administering a PRN hypnotic (like Ambien). Our facility chose to document these interventions on our Behavior Tracking form. We almost got cited for not documenting these interventions but were able to show other documentation that convinced the surveyor that we were in fact attempting other interventions prior to the PRN Ambien.

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Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

True- Ambien does not require behavior monitoring ....however....it does require documentation of use and, as has been stated, non-pharmological interventions that were tried before administering, as well as care planning. Please read F329- also Ambien cannot be used long term without good documentation from the physician as to the need and pharmacy reviews.

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