10- 144 C.M.R. ch. 118, § 8.C

Current through 2025-03, January 15, 2025

Section 144-118-8.C - Drug Usage

09/01/07 8.C.1. Drugs Used for Control of Inappropriate Behavior

a. For these drugs to be an effective therapeutic tool, they must be prescribed only to the extent that they are necessary for management of the client.

b. Each use of a chemical restraint shall be ordered by a physician. Such order shall be signed by the physician as soon as possible after use of the drug. The physician's findings must be noted in the client's record.

c. In an emergency, a physician may authorize the use of a drug to modify an inappropriate behavior. However, orders for continued emergency drug usage cannot continue beyond twelve (12) hours unless:

1. The drug usage has been reviewed by the Interdisciplinary Team; and

2. The drug's use is included as an integral part of the client's individual program plan that is directed specifically towards the reduction of and eventual elimination of the behaviors for which the drug is employed.

d. Psychotropic drug therapy may not be used outside an active treatment program targeted to eliminate the specific behaviors, which are thought to be drug responsive.

e. When drugs are used for control of inappropriate behavior, documentation that alternative interventions have been considered and tried must be contained in the client's record.

09/01/07 8.C.2. Drugs used for control of inappropriate behavior must not be used until they have been justified in writing by a member of the IDT, that the harmful effects of the behavior clearly outweigh the potentially harmful effects of the drugs.

09/01/07 8.C.3. Drugs used for control of inappropriate behavior must be:

a. Assessed at time of medication change;

b. Monitored by the:

1. Physician, at least as often as the drug and client's condition requires;

2. R.N. or Pharmacist, at least monthly;

3. Pharmacist, at least quarterly; and

4. Facility staff, as often as is necessary to determine whether the desired response is being attained or there are any adverse consequences, e.g., motor restlessness, Parkinson's symptoms, Tardive Dyskinesia.

10- 144 C.M.R. ch. 118, § 8.C