| HSAG Toolkit |
Improving Dementia Care:
Reducing Antipsychotic Medication Use in Nursing Homes
Antipsychotic Medication Reduction Toolkit***NEW View the entire Toolkit: ONE CONTINUOUS PDFTable of Contents(PDF of Table of Contents) Tab 1. HSAG of California Reducing Healthcare Acquired Conditions Project a.) HSAG of California NHQCC Brochure ..............................................................................4 pages Tab 2. CMS National Partnership to Improve Dementia Care in Nursing Homes Initiative Launch of the Initiative to Improve Behavioral Health and Reduce the Use of a.) Antipsychotic Medications in Nursing Homes Residents..................................................46 pages b.) CMS National Partnership to Improve Dementia Care in Nursing Homes Initiative............2 pages c.) AMDA Letter .................................................................................................................... .4 pages Tab 3. RESERVED (No Content) Tab 4. Regulatory References a.) CMS S&C: 13-35-NH ...................................................................................................... 59 pages b.) CDPH L&C SNF Antipsychotic Use Survey Tool.................................................................5 pages c.) CDPH Antipsychotic Use Survey Tool–Supplemental Guidance ........................................8 pages d.) Surveying to Antipsychotic Use in SNFs ..........................................................................16 pages e.) Federal Surveyor Checklist ................................................................................................2 pages Tab 5. MDS Reference Material a.) RAI Manual Section A ......................................................................................................29 pages b.) RAI Manual Section I ...................................................................................................... 10 pages c.) RAI Manual Section N ....................................................................................................... 9 pages d.) Appendix C: CAA Resources .......................................................................................... 85 pages e.) MDS 3.0 Quality Measure User’s Manual v.8.0 ...............................................................80 pages Tab 6. Policy & Procedure a.) Sample Psychotropic Medication Policy ............................................................................3 pages b.) Provider Implementation Flow Diagram.............................................................................4 pages Tab 7. Assessment a.) Partnership to Improve Dementia Care in Nursing Homes State Coalition Provider Question Worksheet (Self-Assessment Tool) ................................................................................................................................................2 pages b.) Partnership to Improve Dementia Care in Nursing Homes Suggestions for Provider Checklist ................................................................................................................................................. 1 page c.) PAINAD Assessment ......................................................................................................... 2 pages d.) Cornell Depression Scale ................................................................................................... 1 page e.) Cornell Depression Scale Guide....................................................................................... 12 pages f.) Antipsychotic Use in Dementia Assessment ........................................................................2 pages g.) Psychopharmacologic Interdisciplinary Medication Review/ Gradual Dose Reduction Assessment .................................................................................................................................................2 pages Tab 8. Advancing Excellence in America’s Nursing Homes Resources a.) Anti-Psychotropic Reality Reductions (PowerPoint) .............................................................8 pages b.) A Perspective on CMS’s Antipsychotic Reduction Initiative (PowerPoint) ......................... 24 pages c.) Antipsychotic Medication Reference ................................................................................... 7 pages d.) Reducing Inappropriate Use of Antipsychotics in Nursing Homes Part 1 .............................8 pages e.) Reducing Inappropriate Use of Antipsychotics in Nursing Homes Part 2 .......................... 28 pages Tab 9. SBAR for Antipsychotics a.) SBAR: Reducing Antipsychotics in Nursing Homes ......................................................1 page Tab 10. Care Planning a.) SMART Objectives ............................................................................................................... 3 pages b.) Questions to Consider in Interdisciplinary Team Review of Individual Dementia Care Cases ....................................................................................................................................................2 pages c.) Care Plan – Reducing Antipsychotic Medications .................................................................. 1 page d.) 101 Non-Pharmacological Interventions............................................................................... 2 pages e.) NHS “This is Me” Booklet ......................................................................................................4 pages f.) DOT-COM Pre-Admission Person-Centered Care Approach ................................................. 1 page g.) DOT-COM Resident Review: Describing Needs-Driven Behavior (NDB) Expressions ..........2 pages h.) DOT-COM Identifying Potential Causes of Needs-Driven Behavioral (NDB) Expression Symptoms ....................................................................................................................................................2 pages i.) Resident History, Profile, and Who Am I? Info Sheet.............................................................. 1 page j.) Who Am I? ............................................................................................................................. 1 page k.) Resident Profile .....................................................................................................................2 pages Tab 11. Family Education a.) Antipsychotic Medicines for People With Dementia .............................................................. 4 pages b.) NIMH-Mental Health Medications ....................................................................................... 30 pages c.) Family Involvement in Care .................................................................................................. 4 pages d.) Antidepressant Medication Information..................................................................................2 pages e.) Antipsychotic Medication Information ................................................................................... 2 pages f.) AHCA Fast Facts: What You Need to Know About Antipsychotic Drugs for Persons Living with Dementia ....................................................................................................................................................2 pages Tab 12. Staff Education The University of Iowa Geriatric Center Info-Connect Resources: a.) Oral Hygiene Care for Nursing Home Residents with Dementia...........................................6 pages b.) Managing Bathing Challenges in Nursing Home Residents with Dementia .........................4 pages c.) Pain Assessment in Nursing Home Residents with Dementia .............................................4 pages d.) Pain Management in Nursing Home Residents with Dementia .......................................... 4 pages e.) Understanding & Managing Aggression...............................................................................4 pages f.) The 3Ds: Delirium, Depression, Dementia ...........................................................................4 pages The University of Iowa Geriatric Center Info-Connect 4-Part Series, Needs-Driven Behavior: g.) Need-Driven Dementia-Compromised Behavior (NDB) (Part 1) .........................................4 pages h.) Disruptive Vocalizations (Part 2) ........................................................................................ 4 pages i.) Sleep Disturbances (Part 3) ................................................................................................ 4 pages j.) Great Escapes: The Wandering Dilemma (Part 4) ...............................................................4 pages Additional Resources: k.) Antipsychotic Use in Dementia .......................................................................................... 27 pages l.) Delirium Assessment and Management ............................................................................. 11 pages m.) AHCA Quality Initiative Toolkit: Clinical Considerations of Antipsychotic Management .................................................................................................................................................35 pages n.) Pioneer Network Dedicated/Consistent Caregivers Tip Sheet .............................................4 pages o.) Pioneer Network Shift Huddles Tip Sheet ........................................................................... 2 pages p.) AGS Beers Criteria Article...................................................................................................16 pages q.) Managing a Crisis.................................................................................................................2 pages Tab 13. Quality Improvement a.) Current Process Analysis ................................................................................................... 2 pages b.) QAPI “At A Glance” ............................................................................................................41 pages c.) HSAG-CA Antipsychotic Medication Reduction Case Study ................................................2 pages d.) HSAG-CA Antipsychotic Medication Reduction Case Study (PowerPoint) .........................13 pages e.) 5-Whys.................................................................................................................................2 pages Tab 14. Medical Record Review Tool a.) Partnership to Improve Dementia Care in Nursing Homes Suggestions to Provider Checklist .................................................................................................................................................... 1 page b.) Federal Surveyor Checklist .................................................................................................. 2 pages Tab 15. QIS Forms a.) Admission Sample Record Review ...................................................................................... 3 pages b.) Resident Interview & Resident Observation ........................................................................ 8 pages c.) Staff Interview ...................................................................................................................... 4 pages d.) Census Sample Record Review............................................................................................3 pages e.) Stage 2 Critical Elements for Unnecessary Medications ......................................................5 pages f.) Stage 2 Critical Elements for Behavioral and Emotional Status ..........................................14 pages g.) Stage 2 Critical Elements for Pain Recognition and Management......................................16 pages h.) Stage 2 Critical Elements for the Use of Physical Restraints ..............................................15 pages i.) Sufficient Nursing Staff Review ..............................................................................................4 pages j.) Abuse Prohibition Review ......................................................................................................7 pages Tab 16. Pocket Guides a.) Problem Behaviors ................................................................................................................ 1 page b.) Delirium Management and Screening Tool............................................................................ 1 page c.) Drugs that Cause Delirium or Problem Behaviors.................................................................. 1 page d.) Non-Drug Pocket Guide......................................................................................................... 1 page e.) Dementia Antipsychotic Guide for Care Providers................................................................. 1 page f.) Dementia Antipsychotic Prescribing Guide (Part 1).................................................................1 page g.) Dementia Antipsychotic Prescribing Guide (Part 2)................................................................1 page h.) Algorithm for Treating Behavioral and Psychological Symptoms of Dementia ......................1 page Tab 17. Informed Consent a.) Title 22 Informed Consent.....................................................................................................3 pages b.) CAHF Informed Consent (PowerPoint)................................................................................24 pages c.) CAHF Care Considerations-Resident With Behavior and Psychotic Symptoms of Dementia..................................................................................................................................18 pages d.) CAHF Informed Consent Toolkit .........................................................................................13 pages Tab 18. Web site References a.) Improving Dementia Care, Reducing Antipsychotic Medications Helpful Web Sites ............ 2 pages b.) OASIS Resource Document..................................................................................................2 pages Acknowledgements |