Background: Australia’s Clinical Practice Guideline for the Appropriate Use of Psychotropic Medications in People Living with Dementia and in Residential Aged Care recommends structured adverse drug event (ADE) monitoring for residents using antipsychotics, benzodiazepines and antidepressants. This study evaluated factors associated with the uptake of psychotropic ADE monitoring in residential care homes (RCHs). Methods: Mixed-methods analyses of data from the 12-month EMBRACE trial involving 19 RCHs from 4 organisations. Quantitative uptake of ADE monitoring was measured at baseline, 3, 6, 9 and 12 months for residents living with dementia using a psychotropic with ADE monitoring in place. Uptake was examined by RCH size (number of residents) and organisation. Qualitative data from RCH-specific local action plans and semi-structured interviews with knowledge brokers, general practitioners, nurses, aged care workers and managers were analysed deductively using the Consolidated Framework for Implementation Research. Results: There was a 37% absolute increase in psychotropic ADE monitoring for antidepressants, 54% for antipsychotics, and 50% for benzodiazepines. There was variation in uptake based on RCH size (70% for <65 residents, 22% for 65-99 residents, 25% for ≥100 residents) and organisation (between 2% and 99%). Engaging clinical staff involved in monitoring ADEs (Innovation Deliverers) and RCH managers (Mid-level Leaders), and leveraging Information Technology infrastructure to integrate ADE monitoring into workflow, were the strongest factors associated with the uptake of psychotropic ADE monitoring. Conclusions: Psychotropic ADE monitoring can be integrated into RCH workflows, with staff engagement, leadership buy-in and appropriate information technology infrastructure seen as key enablers.