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MED-PASS:  The Fine Art of Document Design

Behavior/Intervention Monthly Flow Record - 100/pad


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Price: $13.50
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This form has been revised to reflect the November 9, 2016, changes to the State Operations Manual regarding Unnecessary Medications.

To provide a systematic approach to monitoring and documenting maladaptive behaviors, med and non-med interventions, outcomes and potential medication related side effects for residents currently on or being considered for a psychoactive medication regimen.

  • Allows charting of 3 maladaptive behaviors.
  • Prompts for charting, by shift, by day, of number of behaviors episodes observed, intervention, outcome and side effects, if observed.
  • 11 non-med interventions coded for staff to choose from plus space to list 3 additional interventions.
  • Outcome codes provided and space to list 3 med related side effects.
  • Back contains reference for behaviors and potential side effects coded with associated psychoactive medication classes, comments section and section for listing observer initials and signatures.
Size 8-1/2 x 11
Unit Pad of 100
Orientation Horizontal
Other Info Handwritten
Hole Punch 3 holes top

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