Improving Antipsychotic Agent Use in Nursing Homes: Development of an Algorithm for Treating Problem Behaviors in Dementia
Authors: Smith Marianne , Schultz Susan K. , Seydel Linda L. , Reist Jeffrey , Kelly Michael , Weckman Michelle , Gryzlak Brian , Carnahan Ryan 
Published: March 2013

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Instructions

1.3
contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at
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1.
Read the article, “Improving Antipsychotic Agent Use in Nursing Homes: Development of an Algorithm for Treating Problem Behaviors in Dementia” found on pages 24–35, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz.

2.
Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study.

3.
Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated.

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Contact Hours
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Activity Objective

1.
Describe the development of an algorithm for treating problem behaviors in nursing home patients with dementia that can improve the use of antipsychotic agents.

Disclosure Statement
Neither the planners nor the authors have any conflicts of interest to disclose.

Many issues related to safety and quality care emerge from reports that nearly one in three nursing home residents is treated with antipsychotic medication, a rate that exceeds levels that led to nursing home reform more than 2 decades ago. Atypical antipsychotic medications have become the mainstay of treatment for behavioral problems among residents with dementia, despite federal “black box” warnings about health risks and research demonstrating their limited effectiveness. The purpose of this article is to briefly describe a dissemination research project designed to increase appropriate antipsychotic prescribing for older adults with dementia. A step-wise problem-solving algorithm designed to reduce unnecessary psychotropic medication use is described. Formative evaluation results provided by nursing home personnel are reviewed. Discussion focuses on nursing home culture as an important influence on the adoption of evidence-based practices and changes needed to promote use of behavioral interventions in dementia care and reduction of reliance on antipsychotic medications.