Friends Hospital cited for violating policy on use of psychotropic medications

The Friends Hospital Inpatient Unit was cited by the Pennsylvania Department of Human Services (DHS, formerly known as the Dept. of Public Welfare) for deficiencies related to patient rights – the right to treatment, adequate treatment, use of PRN (as needed) medications, use of seclusion and restraint, and information release to third parties. DHS reviewed the Friends Hospital Policy and Procedure for PRN Medication and found that PRN psychoactive medications in the facility are only to be utilized as a planned intervention based on documentation in the patient’s treatment plan. However, DHS found that the facility was not recording the use of PRN medication as “interventions on treatment plans as per hospital policy.” The facility was also not consistently documenting the reason and efficacy for psychotropic medications that were administered as PRN. Also, the corresponding notes to justify the usage of PRN medication were missing. DHS also found that the seclusion and restraint documentation for one consumer did not have the recorded dosages of Ativan given in the EMR. DHS also noted that the “times medications were given during a seclusion & restraint episode did not reconcile with the EMR in three separate restraint episodes” for the same patient. DHS also found 9 of 14 charts in which observation sheets were blank in some areas, illegible, and missed signatures. Friends Hospital was cited for a repeat citation after DHS found 6 of 14 charts were out of compliance with regulations for the consensual release of medical information to third parties. In the plan of correction, the facility agreed to address the cited deficiencies and educate all staff on the hospital’s policies and procedures.