Date of Graduation
Fall 12-12-2025
Document Access
Project/Capstone - Global access
Degree Name
Master of Science in Nursing (MSN)
College/School
School of Nursing and Health Professions
Program
MSN project
First Advisor
Tania Borja-Rodrigues
Second Advisor
Robert Patterson
Abstract
Objective: Inappropriate psychotropic medication use and documentation poses a risk to patient safety and health as well as premature death while also leading to regulatory noncompliance (Bednarczyk et al., 2022). Improving nurse documentation can help patients maintain safe and adequate prescriptions and doses. Context: Baseline data collected within our microsystem revealed gaps in nurse comfort and knowledge around documentation requirements. The nursing staff (LVNs/RNs), who we received the baseline data from, are responsible for assessments, documentation, and patient monitoring, for which there is significant variability in understanding the required expectations. Interventions: The education for the skilled nursing staff as well as the standardized flow sheets were provided to increase staff knowledge, comfort, and adherence to documentation standards. Methods: Pre- and post-intervention surveys assessed nursing staff knowledge, confidence, and documentation methods over a 6 week period. Results: Average staff confidence in psychotropic medication documentation increased from 44.4% to 60.7%. Nurse knowledge of the documentation processes improved from 80% to 85.7%. Conclusion: Focused education paired with structured tools enhance nursing staff competency, supports compliance, and promotes safer, high-quality patient care. Improvements were observed, but findings also show a need for a continued education on psychotropic medication use in addition to standardizing documentation practices due to the percentage decrease in knowledge between the pre and post intervention surveys. Future efforts will include ongoing staff education on psychotropic medication requirements and evidence-based interventions and EHR charting review and training as requested by staff.
Recommended Citation
Kirkes, Matalyn F., "Enhancing Psychotropic Medication Documentation Through Staff Education to Promote Increased Compliance Rates and Patient Safety" (2025). Master's Projects and Capstones. 1978.
https://repository.usfca.edu/capstone/1978
