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Medication Reviews

Psychotropic Medication Reviews in the CBRF

April 20th, 2013

Wisconsin state regulations (DHS 83) require all psychotropic medications to include quarterly reviews of scheduled regimens and monthly monitoring of “as needed” regimens.  Some important facts to remember:

Notice that the regulations state “at least quarterly”; this means that if resident behaviors, side effects or dosage increases or reductions occur in between regularly scheduled reviews, that additional reviews may be indicated and expected.

These reviews must be done by a practitioner, registered nurse or pharmacist.  A practitioner is defined as a person licensed in Wisconsin to prescribe and administer drugs or licensed in another state and recognized by this state as a person authorized to prescribe and administer drugs. Note that this list does NOT include a licensed practical nurse (LPN).

Three things that should be included in these reviews are:

  1. Is the resident achieving very specific behavioral goals?
  2. Is the resident experiencing any side effects of the medications?
  3. Is a gradual dosage reduction attempt appropriate?

When a psychotropic medication is ordered for a resident:

  1. See that the service plan (care plan) includes specific rationale for its use and a detailed description of the behaviors which indicate the need for administration of the PRN medication
  2. monitor for any inappropriate use of the PRN medications
  3. monitor for proper documentation of the effectiveness of the medication given, the presence of any side effects, and watching for any inappropriate use of the medications.

If needed, Prescriptions Plus can provide you with forms to assist in your compliance with DHS 83 regulations:

  • Psychotropic Medication Regimen Review Worksheet (form PH-13)
  • Chronological Record of Psychotropic Medication Regimen Reviews (form PH-12)
  • Antipsychotic Medication Quarterly Evaluation/AIMS (Med-Pass form MP5562)

Please let us know how we can help.

Insulin Storage Recommendations

April 20th, 2013

Dear Facility Manager,

As you may be aware, the insulin pens administered to your residents have stability limits. The following chart includes the stability of in-use pens at room temperature. We recommend that when a pen is first used, to label it with the date and adhere to the following manufacturer’s recommendations:

Levemir FlexPen                              42 days

NovoLog FlexPen                            28 days

NovoLog Mix 70/30 FlexPen         14 days

Humalog KwikPen                          28 days

Humalog Mix 75/25 KwikPen        10 days

Humalog Mix 50/50 KwikPen        10 days

Humulin N prefilled pen                 14 days

Humulin 70/30 prefilled pen          10 days

Apidra Solostar                                 28 days

Lantus Solostar                                28 days


Note: For any unopened insulin pen which has been refrigerated, the expiration date listed on the pen may still be observed.