28 | It’s Raining Meds: Fixing How We Prescribe for Older Adults

What if a small change in your electronic health record could save lives?In this episode of Nursing Insights, we dive into a quiet revolution in geriatric care: the Geriatric Prescribing Context (GPC). Host Stephanie Olaso, MHCI, BSN, RN  is joined by:Dr. Katie Drago, geriatrician and lead researcher behind the GPCJean Stoerger, PharmD and clinical geriatric pharmacistMary Jo Phillips, DNP and geriatric program directorTogether, they unpack how the GPC came to life after a tragic medical error, how it functions invisibly within Epic to nudge safer prescribing decisions, and what the real-world results look like – like a 50% reduction in dose-related adverse drug events.Whether you’re a nurse, pharmacist, or physician, this episode will challenge the way you think about clinical decision support, EHR design, and the hidden power of tiny nudges in patient care. Key Takeaways:A tragic overdose case involving haloperidol in a 90-year-old patient became the catalyst for the GPC.The GPC adjusts default medication doses in Epic for patients aged 65+, making them more age-appropriate – without pop-ups or hard stops.Implementation led to a 50% reduction in dose-related adverse drug events, with sustained results over 4 years.Most clinicians didn’t even realize it was active – meaning no alert fatigue and seamless workflow.Nurses play a powerful, often overlooked role in influencing prescribing decisions.The GPC is now part of Epic’s foundations package (post-Nov 2023) and available to others via the Community Library. Relevant Links:New Jersey Collaborating Center for Nursing: https://njccn.orgSafer prescribing for hospitalized older adults with an electronic-health record based prescribing context: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.16640Long term impact of a geriatric prescribing context: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.17799In pursuit of the quadruple aim: A geriatric prescribing context’s impact on clinician workflows and alert fatigue: https://journals.sagepub.com/doi/abs/10.1177/07334648221079103Improving dose related adverse drug events among hospitalized older adults using a geriatric prescribing context: https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.18754IHI Age Friendly Health Systems, main page, including overview of the movement and how to join: https://www.ihi.org/partner/initiatives/age-friendly-health-systemsGetting started on an Age Friendly journey: