QA Meeting/Notes:

First meeting for 2011: 2/8/11 at 12:00 PM

Month in review: January 2011
Date review conducted: 2/2/11

Areas of review for Social Services for January:

1. Psychopharmacological medications:
a. Focus for January 2011: Hypnotics
b. Goal: Reduce use of hypnotics

c. Number of residents taking hypnotics: 3

i. G. Moriarty (Ambien)
ii. L. Wright (Ambien)
iii. D. Denis (Ambien)
iv. Dove????

d. Number of residents taking non-hypnotic medications: 5

i. H. Cracraft (Melatonin)
ii. L. Graves (Melatonin)
iii. I. Hancock (Melatonin)
iv. G. Hathcox (Trazodone)
v. E. Herman (Tylenol PM)

e. Successful GDR’s for January: 1

i. R. Lautzenhiser (Melatonin d/c’d 1/25/11)

f. Failed GDR’s for January: 1

i. G. Moriarty (Ambien d/c’d 1/25 and restarted 1/28. CI indicated)

g. Summary:
i. Total percentage of those taking hypnotics (@ 80 res.): 2.4%
ii. Total percentage of those taking non-hypnotics (@ 80 res.): 4%

h. Conclusion:
i. It is encouraging to note that we currently have fewer residents
taking hypnotic medications to help with sleep disturbance.
During the month of January, it is noted that only three residents
are taking hypnotic medications. Of the three residents taking
Ambien, one (G. Moriarty) recently failed a GDR of Ambien on
1/25/11. Dr. Alley agreed with IDT’s recommendation on 1/28/11
for no further reductions on this medication for this resident.
Another resident (L. Wright) taking Ambien is under care of
hospice due to end-stage cancer. In light of her continued state of
decline, Ambien may be considered a “comfort measure” and
therefore may not be indicated for a reduction. The last resident
 (D. Denis) was restarted on Ambien on 1/28/11 per Dr. Alley due
to long history of insomnia due to extensive medical issues.
i. Goals:
i. A short-term goal for the area of hypnotic medication would be to
consider reducing the Tylenol PM for E. Herman. (However, it
should be noted that this resident is anticipating short-term
placement with eventual discharge to her home). By next review
(scheduled in May 2011), my goal is to have only one resident
taking hypnotic medication.

2. MDS/Care Plan/CAA Reviews:

a. Ask Dee

3. Delirium:
a. Total number of residents who triggered delirium during January: N/A

b. Summary:
i. Following a discussion with the MDS Coordinator, it was noted
that no residents triggered an area of concern for delirium during
the month of January.

c. Goals/Conclusion:
i. Maintain 0% of indicators for delirium through next review.