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MED-PASS:  The Fine Art of Document Design

Psychoactive Medication Monthly Flow Record - 100/pad


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Price: $13.50
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Order Reminder Program

This form has been revised to reflect the December, 2006, changes to the State Operations Manual regarding Unnecessary Medications.

To provide a systematic approach to monitoring and documenting maladaptive behaviors and medication related side effects for residents on a psychoactive medication regimen for DX of organic mental syndrome.
  • Allows charting of 4 maladaptive behaviors and 6 potential drug side effects.
  • Prompts for documentation by day, by shift, of number of behavior episodes and potential side effects observed.
  • Key containing 11 common maladaptive behaviors coded and space for listing 3 additional behaviors provided for nursing staff to choose from.
  • Keys containing coded side effects specific to Antipsychotic Non-Movement Side Effects and Movement Side Effects and Anti-anxiety/Sedative side effects with space to list additional side effects provided.
  • Back contains section for nurses' progress notes, observer initials and signatures and drug reference including appropriate usage indicators, drugs by class (brand and generic names) and recommended dosages
Size 8-1/2 x 11
Unit Pad of 100
Orientation Horizontal
Other Info Handwritten
Hole Punch 3 holes top

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