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THE MEDICATION ADMINISTRATION RECORD (MAR) SHEET/CHART

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THE MEDICATION ADMINISTRATION RECORD (MAR) SHEET/CHART

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This is a formal record of the medications and the date when they were administered.

MAR chart good practice includes:-

The MAR chart is individual to the person and reflects the items which are still being currently prescribed and administered

The MAR chart is clear, indelible, permanent and contains product name, strength, dose frequency, quantity, and any additional information required.

The MAR chart incorporates a method to ensure that any changes made after production are evident. (dated, signed and indicates who has made the change)

NEVER complete the MAR beforehand

Check that you have the correct date, don’t just initial the next box!

Initial so that you can be identified

Cross out mistake – not scribble

Record signing errors on Carers Notes

Use correct codes for non-administration

Explain codes in Carers Notes

Use the Carers Notes on the reverse of the MAR to record:-

An individual’s refusal to take medication

When errors in administration of the medicine occur (e.g. incorrect dose, incorrect medicine, to wrong individual etc).

Why PRN medication was administered

Use a black ball point pen

Hand written MAR must be checked and countersigned

Alterations to MAR must be checked and countersigned

MAR should list each separate medicine and MUST match exactly what is on the medication pharmacy label

PRN/ as directed / when required – needs a PRN protocol

Topical medication – requires a body map

PRN topical medication – requires a PRN protocol AND a body map

Note: PRN stands for Pro Re Nata which translated to “as and when required”.   Social Care Workers must have clear instructions from the GP when to administer the medication, the Social Care Worker must never be expected to decide whether to administer or how much to administer. The GP’s instructions should be recorded on a PRN protocol.

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SOME DO'S AND DON'TS WHEN ASSISTING WITH MEDICATION

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SOME DO'S AND DON'TS WHEN ASSISTING WITH MEDICATION

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These are sometimes called:-

Dossette boxes

Blister packs

NOMAD trays

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Some controlled drugs require controlled drugs storage, some require a controlled drugs register and record (2 signatures). Follow the policy on this. The storage and recording requirements do not apply in the individuals own home.

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8. If the medication is a cream, check the body map to see where it is to be applied and apply as prescribed, always wear PPE gloves, remove the gloves and initial the MAR.

9.If the medication is a transdermal patch, check the leaflet (PIL) and administer as instructed. Always wear PPE gloves, remove the gloves and initial the MAR

10. If the medication is drops, do not let the dropper touch the individuals body, follow the instructions on the leaflet and initial the MAR

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                                 ERRORS & HOW TO AVOID THEM

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                                 ERRORS & HOW TO AVOID THEM

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Errors include:

Giving the medication at the wrong time

Giving medication to the wrong person

Giving too much or too little medication

Spoiling medication

Signing the MAR in the wrong place

Forgetting to give medication

Forgetting to sign the MAR

Cause of errors:

Not following the procedure

Rushing

Auto pilot

Complacency

Lack of concentration

Lack of medicine training

Interruptions

Lack of team work between Care Provider , Surgery and Pharmacy

Inefficient ordering systems

Inaccurate medication records

Verbal communication.

** IF YOU MAKE AN ERROR - REPORT IT & FOLLOW THE MEDICATION POLICY & PROCEDURE**

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If they are supplied and filled by the pharmacy then these are acceptable, if they have been filled by the individual, their family or by care workers then they are not acceptable.

There is a move away from multi-compartment aids and in the future they will only be used as a reasonable adjustment to support the individual to take their own medication.

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     THE 6 RIGHTS OF MEDICATION ADMINISTRATION

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     THE 6 RIGHTS OF MEDICATION ADMINISTRATION

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1. Right dose, of the

2. Right medication is given to the

3. Right person at the

4. Right time by the

5. Right route or method

6. They have the right to refuse

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Check the MAR

1. Check the medication packaging, the medication label must match the MAR

2. Check that you have the right medication for that individual at that time, note if the medication is required to be taken “with food”

3. Check that you have the individuals consent

4. Release the first medication from the packaging (if tablets) into the individuals hand, offer them a drink (200ml of water approx.), when they have swallowed the tablet, initial the MAR

5. Repeat step 5 for the next medication and so on.

6. If liquid, measure the correct dose. The correct measure is where the bottom of the meniscus curve touches the mark on the medicine pot, offer it to the individual, when they have swallowed the medication, initial the MAR.

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Contraindications:
These are situations in which a drug should not be used because it may be harmful to the person. There are two types of contraindications:

Relative contraindication means that caution should be used when two drugs are used together. (It is acceptable to do so if the benefits outweigh the risk.)

Absolute contraindication means the drug or substance  could cause a life-threatening situation. A medicine that falls under this category must be avoided.

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Side effects:
These are sometimes called adverse effects.  They are an unwanted complication of medication. Side effects are most common:-

When the individual starts to take a new medication

When the dose of the medication is changed

When the medication is stopped.

The Patient Information Leaflet (PIL) provides information on side effects

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Medicines are a drug or preparation for the treatment or prevention of disease.

Social Care Workers should know why the person is prescribed that medication, this information is usually in the individuals care plan.

Medicines include prescribed and non-prescribed drugs. Non-prescribed drugs include pharmacy only (sold in the presence of a pharmacist) and over the counter (OTC) medications.

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Tim Dallinger who has assisted with the content.
And to Acute training who have supported our eLearning programme

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1: Use the bar on the bottom   (or swipe) to scroll down.
2: Use the bar to the right to scroll across the board.
3. Double click on images/links/powerpoints/videos to access the full information (or to play the videos).
That's it - you're good to go!

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WELCOME TO THE SAFE ADMINISTRATION OF MEDICATION TOOLKIT 

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WELCOME TO THE SAFE ADMINISTRATION OF MEDICATION TOOLKIT 

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We hope you find this resource of use, if you have any comments or suggestions please contact:
Cerileigh.evans@torfaen.gov.uk

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**DO NOT administer medication if you are not competent and FULLY understand the instructions for each medication, including the dose and administration route**

DO NOT dispense or administer medication if the instructions on the box/blister pack/container is different from that on the MAR sheet seek advice from Senior staff member.

DO NOT prepare or give medication prior to the correct time e.g.Medication prescribed for morning can only be removed from the container/blister pack immediately prior to administration and given in the morning: it cannot be left out the night before to be taken the following morning

DO NOT be distracted when administering medication. If distracted in any way stop what you are doing immediately; deal with the distraction and then recommence administration of medication.

AND THE DO's:
DO keep the handling of medication to an absolute minimum. Wherever possible, medications should be blister packed:.

If you need to physically touch the medication then a clean pair of gloves must be put on prior to touching the medication and removed afterwards. ·

You must always wear gloves when you assist with skin applications ·

You must replace all lids and packaging immediately after dispensing

DO dispense and administer medication to one person at a time and WATCH THEM TAKE IT

DO ensure individuals are sitting upright when taking medicines. It is recommended to take at least half a tumbler of water (or cold drink) with tablets.

DO report any problems or concerns to your senior immediately