Week January 11
High-Risk Medications
Several steps may help avoid patient issues as well as OASIS compliance related to high-risk medications:
1) Identify what quality organization or source you will use to help you identify high risk medications such the Institute for Safe Medication Practices, JCAHO, or (for elderly) the Beers criteria. High risk meds include anticoagulants, antipsychotics, diuretics, and anti-epileptics.
2) Pay special attention to whether patients really need these high risk medications. Don’t assume the physician signing the 485 is the one who put the client on this medication. For example, consider the client who is on Coumadin to prevent clotting post-hip replacement. However, the hip replacement occurred 2 years ago. Some sources report that such prophylaxis has a limited time period for clinical effectiveness - usually three months. Speak with the physician about getting the client off this medication.
3) For elderly clients, review their list of medications against the Beers criteria. For a list of these medications, go to: http://www.dcri.duke.edu/ccge/curtis/beers.html
4) When feasible, involve the patient and family in medication discussions, especially if the client has multiple physicians prescribing medications.
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