Table 5 Indicators to assess aggregate RACF-level concordance: antipsychotics

1

Residents using antipsychotics have documentation of experiencing distressing psychotic symptoms and/or aggression/agitation within the past 12 weeks that represents a direct threat to either the resident or other residents, staff, or family for the resident’s prescription of the antipsychotic

GPS 9; CR 3

2

Residents using antipsychotics have documentation of individually targeted non-pharmacological management strategies to manage distressing psychotic symptoms and/or aggression/agitation that are currently in place

GPS 6

3

Residents using antipsychotics are using a second-generation antipsychotic

CR 1

4

Residents using antipsychotics have documentation of informed consent for use of the antipsychotic

GPS 8

5

Residents using antipsychotics have a documented date of next review for antipsychotic treatment effectiveness

GPS 10

6

Residents using antipsychotics have a current antipsychotic adverse event monitoring protocol in place

GPS 20

7

Residents using antipsychotics have used the current antipsychotic for less than 12 weeks

GPS 19; GPS 21

8

Residents using antipsychotics for more than 12 weeks are currently having the antipsychotic dose tapered

GPS 19; GPS 23

9

Residents using antipsychotics for more than 12 weeks and not currently tapering have documentation that the resident has been reviewed by either a psychiatrist or geriatrician, a formal documented discussion between the prescriber and a psychiatrist or geriatrician in which both practitioners agree or a documented clinical review involving the prescriber and at least one other medical practitioner in which both practitioners agree

GPS 19; GPS 21; GPS 22