LTC - Texas- PRN Antipsychotics Yes or NO?

[SirKDJ]

I think I remember being told that in the LTC setting you may not have a PRN medication for say, Haldol, or Zyprexa, if the resident is not currently on a scheduled regimen of the same.

I have searched and searched for a law or reg out there to confirm or deny this, but to no avail. It has become a heated discussion among some of my co-workers as I seem to be the only one that has heard of this, even with supervisors. If I am wrong, I am wrong. But no one seems to be able to give me a solid answer yes or no.

Am I mistaken?

If not, can someone direct me to an official site that corroborates this?

Thanks in advance for your input!

[buffalo2122, ADN, BSN, MSN]

if it could be used as a restraint then no i wouldn't use it. MD shouldn't even have that on the MAR prn. He's just being lazy because he doesn't want a call every night for an order to give Haldol to the sundowners who get crazy. Trust your instinct. IF it smells fishy then its probably a fish.

[VANurse2010]

I don't know if it's a "regulation" but it would be highly inappropriate. If the patient is not on scheduled anti-psychotics with documented need for PRN doses, then the provider should be notified about a change in condition and given the decision to prescribe a one time dose of these medications. I am also not a fan in general of internists/family medicine doctors that are most often the medical directors at LTC facilities prescribing anti-psychotics long-term for behavior management. Now, I'm not one of these uninformed lay people who believes sloppily written news stories about demented elders being snowed with anti-psychotics, neglected, and exposed to statistically premature death - however, I believe a geriatric psychiatrist should be consulted and involved in decisions to prescribe long-term antipsychotics for dementia with behaviors.

[SirKDJ]

Thank you both for your responses, they are most helpful!