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Module 3: When Wrong Things Happen with Medications:
Risk and Prevention - The Role of the Medication Team in Preventing and Managing Problems with Medications

Module 3 addresses:

  1. Conditions leading to ADEs in nursing homes and other long term care settings.
  2. Optimal drug prescribing practices for older adults.
  3. Roles of various health care professionals and caregivers in medication management.
  4. A quality improvement approach to preventing ADEs.

When Wrong Things Happen with Medications:
Risk and Prevention - The Role of the Medication Team in Preventing and Managing Problems with Medications

Written by:

Donna Miller, DO
Director, Geriatrics Institute
St. Luke's Hospital & Health Network
Bethlehem, PA

Reviewed and updated in fall 2006 by:
Johanne Louis-Taylor, MSN, CRNP,

GEC Series Editors

Reviewed and updated in spring 2012 by:

Donna M.Lisi, PharmD, BCPS, BCPP, and

Tamara Zurakowski, PhD, GNP-BC

Older adults, particularly nursing home residents, are especially vulnerable to Adverse Drug Events (ADEs) due to the number of drugs prescribed for them, prolonged use of medications or inappropriate prescribing practices. An ADE can be defined as an injury resulting from the use of a drug and includes any type of medication error. The Centers for Medicare and Medicaid Services (CMS) differentiate between adverse drug reactions, unexpected responses to a medication, and medication errors, which are mistakes in the prescription or administration of medications. Both will be addressed in this module as ADEs.

Medication use in long term care settings is highly regulated, a practice that started with the landmark Nursing Home Reform act of 1987. Many updates and revisions have been made to those initial regulations, based on research on the specific problems that older adults may experience with medications. Licensed nurses who work with older adults must take the time to remain up-to-date on the evolving information about medicating older people.

A team approach is very useful in reducing medication errors and optimizing drug-prescribing practices. Such a team includes at the core nurses, physicians, and consulting pharmacist,
and is enhanced by dietician, speech-language, occupational and physical therapists as well as nursing assistant, recreational, music, social work and chaplaincy staff.

The teaching materials for this module include a PowerPoint presentation with speaker's notes and a video. Please make sure to download the video as the PowerPoint presentation makes mention of the video.

If you are using Firefox on a PC, right click on the video link and select, "Save link as...." If you are using Internet Explorer you will select, "Save Target As...."

If you are using a Mac, press the Control key and click on the video link and then select "Save link as...".

If you would like to create handouts from the PowerPoint file for your attendees and do not know how, please visit the following link:

How to Create Handouts for Attendees from PowerPoint

If you would like to create a printout of the slides that also contains the notes for the instructor, please visit the following link:

How to Create Notes Pages for Presenters in PowerPoint

Please note that there is a Disqus commenting field at the bottom of this page. The Geriatric Education Center of Greater Philadelphia would greatly appreciate any feedback.

Teaching Materials

Generic module files:

How to Use This Module

Logistics Checklist

Module-specific files:

Medications Module: Introduction

Medications Module: Key Concepts

Medications Module: Learning Objectives

Medications Module: Instructor's PowerPoint Slides with Notes

Medications Module: Video

Medications Module: Pre-Test and Answer Key

Medications Module: Post-Test and Answer Key

Medications Module: Participant Evaluation

Medications Module: References List


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