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Job aids

Side effects, errors and psychotropics: the steps to remember

The short step lists from each lesson of Side effects, medication errors and psychotropic medications, on one page. Print it for the station or the break room. Each list points back to its lesson, where the sources are linked.

Open the coursePrint a poster with a QR code

Decision guide

A medication worry on shift: what do I do?

Does the resident face what looks like a life-threatening crisis, such as not waking?

  • Yes

    Call 911 now. Then tell your supervisor, and write down the times and what you saw.

  • No

    Did help with a medication not match her order and label, or come from another resident's container?

    • Yes

      Check on her and stay close. Tell your supervisor at once. Do not add or skip a dose to make up for it. Write the facts, the times and who you told.

    • No

      Since a medicine started or changed, has she changed in how she acts, eats, sleeps, moves or talks?

      • Yes

        Write what you saw, when it began and how it differs from her usual. Tell your supervisor. Do not name a cause or change the medicine.

      • No

        Is she refusing a medication, or is someone suggesting hiding it in food or drink?

        • Yes

          Do not force, hide or trick. Follow your facility's refusal procedure and tell your supervisor.

        • No

          Is it a PRN medicine for a resident who can neither judge her need nor describe her symptoms?

          • Yes

            Do not decide she needs it. Staff call the physician before this dose, describe her symptoms and get direction. Record the call, the directions, the dose and her response.

          • No

            Help as her order and label direct and record it in your home's system. Anything unclear: ask your supervisor before you help.

A job aid, not a rule book. It does not replace the physician's orders or your facility's procedures, and it never asks you to decide what a symptom means or whether a medicine is right. The licensee decides what is reported to licensing.

Step through it one question at a time: alwbeta.com/training/courses/side-effects-errors-psychotropics#decision-guide

Lesson 1

Notice and describe a possible side effect

A resident seems different after a medicine starts. She is sleepier, shakier or more upset than usual. You do not decide why. But you may be the first to see it. This lesson prepares what you notice, how you put it into words, and who you tell.

  1. What changed, compared with her usual
  2. When it began, and any new or changed medicine
  3. Describe it; leave the cause to the physician
  4. PRN dose: date, time, dose and her response
  5. Tell your supervisor now; the physician's number is on hand
  6. Imminent threat to health: 911 first

Lesson: alwbeta.com/training/courses/side-effects-errors-psychotropics#lesson-sefx-notice-describe

Lesson 2

When a medication error happens

A medication error can happen on any pass: the wrong container, a dose too soon, a dose missed. What you do in the next minutes matters. This lesson prepares you to spot help that does not match the order, check on the resident, tell the right person and write down what happened.

  1. Her own container, matching the order and label
  2. Error: check on her first; imminent threat means 911
  3. Tell your supervisor at once
  4. No extra or skipped dose to make up for it
  5. Write the facts, the times and who you told

Lesson: alwbeta.com/training/courses/side-effects-errors-psychotropics#lesson-sefx-medication-errors

Lesson 3

Psychotropic medicines and residents with dementia

Many residents with dementia take a medicine that acts on the mind or mood. Two California training laws name the risks of these medicines. You do not choose or change them. This lesson prepares you to know what the laws name, so you watch for the right changes and report them.

  1. Psychotropic: acts on the mind or mood; an antipsychotic is one kind
  2. The law names adverse effects and a higher risk of death in dementia
  3. Watch for changes after a medicine starts or changes
  4. Describe and report; the physician decides about the medicine
  5. Try person-centered approaches and report what works

Lesson: alwbeta.com/training/courses/side-effects-errors-psychotropics#lesson-sefx-psychotropics-dementia

Lesson 4

Her choice: refusal, consent and PRN rules in dementia

A resident with dementia pushes her pills away. A coworker wants to hide them in her pudding. Another wants to give her as-needed medicine because she is loud. This lesson prepares you to protect her right to say no, and to follow the PRN rule that fits when she cannot tell you what she needs.

  1. No forcing, hiding or tricking; refusal is her right
  2. Follow the refusal procedure and tell your supervisor
  3. Every PRN: signed order and a label with the four items
  4. Cannot judge need or describe symptoms: call the physician before each dose
  5. Record the call, the directions, the dose and her response
  6. Not sure which PRN rule fits: ask your supervisor

Lesson: alwbeta.com/training/courses/side-effects-errors-psychotropics#lesson-sefx-consent-refusal

Lesson 5

Reporting under your facility's procedure

After a side effect or an error, the licensee may have to report to licensing. That report rests on your facts. This lesson shows what goes into a licensee's written report, when it is due, and how your shift note feeds it. Your part is to tell your supervisor fast and write clearly.

  1. Tell your supervisor at once; the licensee reports to licensing
  2. Threat to a resident's health: written report within seven days
  3. Death, or a serious injury the physician names: also seven days
  4. Your note: what happened, the times, what you saw, who you told
  5. Facts in time order; no guesses, no blame

Lesson: alwbeta.com/training/courses/side-effects-errors-psychotropics#lesson-sefx-reporting

Beta’s ALW team, course version 2026.10.5, text checked against its sources on October 22, 2026. Educational only. Not continuing-education, licensure or regulatory credit. Follow your employer’s current procedure and the person’s current plan. Call 911 for a medical emergency.

Call the ALW teamFit check