Healthcare News & Insights

Why e-prescribing may increase patients’ fall risk

E-prescribing through an electronic health records (EHR) system can be beneficial in hospitals for many reasons. But it can also cause problems in some cases – particularly regarding preprogrammed doses of medications for vulnerable patients who may be at risk of falls. 

skd239635sdcA new study from the Journal of the American Geriatrics Society shows why it’s critical for clinicians to double check how much medicine they’re prescribing to patients.

Importance of dosage

According to an article from WebMD about the study, researchers reviewed the records of over 280 patients who fell during their hospital stay at a large, city-based facility. All patients were over the age of 65.

Specifically, the study wanted to see whether prescribing certain high-risk medications, such as sleeping pills, opioid painkillers, benzodiazepines and muscle relaxants, had any effect on patient falls. These medications often play a role in falls because they affect patients’ balance and cause drowsiness.

When looking at the patients’ medical records, researchers discovered that, out of all patient falls they examined, 62% happened with patients who were given at least one high-risk medication in the 24 hours before they fell. Among these patients, 16% were taking two high-risk drugs, and an additional 16% were taking three or more.

Even more alarming: 41% of these medications were automatically set at doses stronger than recommended for older patients in the hospital’s e-prescribing program.

While providers may be manually checking for any potential negative medication interactions from new prescriptions entered into an EHR, they might not always be checking that the requested dosage is appropriate – particularly for younger or older patients. Dosage issues could contribute to falls or other adverse effects in patients.

Making sure patients are receiving the right dose of medication is critical for fall prevention. If vulnerable patients need any medications that increase their fall risk, the default dosage in the e-prescribing system may have to be changed to accommodate their conditions.

Other tactics

Along with making sure that medication dosage is appropriate for the patient’s condition, it’s still important to reduce patients’ risk of falling in other ways.

According to information about falls from the ECRI Institute, patients should be assessed for their fall risk upon admission, as well as if their physical condition changes at any point during their hospital stay.

In addition, all clinical staff should be aware of patients who are at high risk of falling. This info should be noted in the EHR and relayed during handoff conversations between shifts. Patients and their families should also be aware of fall risks so they can take appropriate steps to avoid problems (such as asking for assistance when using the bathroom).

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