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Medication management and resident falls

Long-Term Care Nursing Advisor, May 21, 2004

A major risk factor for falls is the medications residents take. Residents who take more than four medications are statistically more likely to fall than those who take fewer drugs.

There are a number of steps that can be taken to reduce the likelihood of a medication-related fall. At a minimum, an annual review of every resident's medications with an eye toward fall reduction is essential. Nurses and pharmacists involved in skilled or residential care facilities should ensure quarterly audits of 25% percent of the residents' medication regimens so that at the end of the year every resident's medications have been examined.

When auditing, look for psychotropic medications, medications listed on Beer's criteria, diuretics that might be causing nighttime toileting problems, and any resident taking more than four medications routinely. Consider the possibilities of alternative drugs or nonpharmacological treatments that might reduce the number of medications or the amount of medications with troubling side effects. Share your findings with the residents' physicians and encourage trial therapy to see whether other treatments might be just as successful but offer a reduced falls risk.

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