Oklahoma Law Requiring Informed Consent before Use of Antipsychotic Drugs with Nursing Home Residents Signed by Governor
A law recently passed by the Oklahoma legislature and signed by the governor is intended to address the overuse of powerful antipsychotic drugs in the stateās nursing homes. According to research from the Centers for Medicare & Medicaid Services (CMS), Oklahoma has the worst record in the country for using antipsychotic drugs for residents without a psychiatric diagnosis that indicates a need for this class of medications.
Some nursing homes have allegedly used antipsychotic drugs as a chemical restraint to make it easier to control residentsā behavior. Elderly residents inappropriately prescribed these medications are at risk for falls due to over-sedation, accelerated cognitive decline, and increased risk of stroke and pneumonia. These drugs can also mask other conditions or illnesses causing them to be untreated, such as undiagnosed pain, dehydration, and urinary tract infections.
The legislation requires informed consent by the resident, or their responsible party, and the resident must be examined by the physician prescribing the medication and diagnosed with a psychiatric condition prior to giving permission.
The law goes into effect November 1, 2019.
Compliance Perspective
Allowing residents to be given powerful antipsychotic drugs without a psychiatric condition that indicates a need or as chemical restraint may be considered abuse and provision of substandard care in violation of state and federal laws.
Discussion Points:
- Review policies and procedures regarding the use of powerful antipsychotic medications, appropriate diagnosis, and informed consent by the resident or his/her responsible party.
- Train staff regarding the facilityās policies and procedures for the use of antipsychotic medications and the risks associated with them. Staff should also be made aware of the need to report orders for medications prescribed as chemical restraints.
- Periodically audit the medication regimen of residents who are receiving antipsychotic drugs to determine if such medications are appropriate for the individual, are not used as chemical restraints, and if gradual dose reductions are attempted unless contraindicated.
