Medications Level 2 (VTQ)
Course Content
- Introduction
- Legislation, Regulation and Policies
- Medications
- Classification of Medications
- POM and Controlled Medications - Pharmacist
- Types of Medications and Routes of Entry
- Medication Brand Names - Pharmacist
- Covert Medications
- Precautions and side effects
- Prescribing and Prescriptions
- Recording Information
- Storing Medication Safely
- Storage of Medications - Pharmacist
- Safe Disposal of Medication
- Disposing of Unwanted Medications - Pharmacist
- Medication expiry dates - Pharmacist
- Analgesics
- Administration of Medications
- Discussing Medication
- Summary
MAR Process
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So the Medication Administration Record, which is short abbreviated for MAR Sheet, is sort of the lynch-pin of holding together what we do when we are administering medication. It is basically a script. So, on the MAR sheet, it will have the person's name, date of birth, any allergies that the person may have, it will have the GP's name and contact details, and then as it works its way down, it is a 28-day-cycle. So that is split down into 7 days in each week, so Monday to Sunday. Then depending on when you get the medication, not all pharmacies deliver on a Monday for the cycle to work that way, is when you get your start point and start date. On the MAR Sheet is exactly the same as the prescription that you have received from the GP. The information for each medication will be on there, so if the person is taking say, for example, diazepam as a medication, then it would state Diazepam, it would state the strength, say 20milligrams, and it will say if it is a tablet, a capsule, whichever form of medication it is, if it is a liquid. It will clearly state that on there. Then it will have the importance of any indicators of not to be taken with alcohol, not to use heavy machinery, so any warning information would be on there. If it is taken say three times a day, there's then a row of times, so for example you have got 8AM, 12 noon, 4 PM, 8PM, and then there is gaps for more times if someone needed additional medication. So in that there are these boxes all the way along. The boxes are fairly small, and what happens is if the person takes the medication three times a day, so they will take it at 8 oclock, they will probably take it again at 2 oclock and then again at 8 oclock. So those times will be prescribed on there. So when staff administer the medication, they must sign in the box their initials. So somewhere on the MAR Sheet there should be somewhere where each member of staff would write their full name, so for my example, Michael Kidd, and then my initials would be MK. So if anyone comes to audit, they would see on Monday Morning at 8oclock, MK gave medication. So that would be in all boxes where medication would be administered. So that's on there. So each medication that you go through, as I said, you would put a dot on there in the box each time you pop the pill into the pot so you know the medication is in the pot ready to administer, so three tablets would have three dots. Go away, administer, come back, sign your initials on each dot. Now if a service user or customer refuses to take their medication, there is a key on the bottom of the sheet. Now this key is very important as well because again, it is just initials, so if someone has refused, there is an "R" which equals, refusal, so if they refused all of their medication, so the three tablets I have put in the pot, they have said "I am not taking it." We have to then go back and put an R in the box instead of my initials, and on the back of the MAR Sheet you have to explain why the person, so the person who refused because they didn't want to take, and then you would write the three medications down, the time of the medication, the strength, the process and what you have done. So it would be, contact doctor for further information. So this would be the doctor potentially would say ok, you may have to wait until the next time they have taken their tablets to administer, or, whichever other medication they would provide. So this is all condensed onto the MAR Sheet so all that information is readily available to everybody so we can see if someone has refused, if someone is sick after taking their tablet, even a couple of minutes afterwards, we could go back to the MAR Sheet, and even though we have signed it to say they have taken it, we can take that to a V for vomiting or a N for nausea, whichever it may be.There is also room for if they are on leave, so on a home visit, so they have taken their medication with them, we would just put the H in there for either home visit, sometimes the H could be for hospital, because they are actually in hospital, so that is where their medication is. So there is a code for all refusal, hospitalisation, leave, wherever the person may be. So that way we can audit where the medication is at all times. So in real-world practice, the MAR Sheet is our first point for all that happens with someone's medication when it comes into the service, when we count to make sure that on there there is a little space along the bottom where you can actually say how many tablets are in the service, how many have been returned to the pharmacy, if any have been destroyed. It is all on this MAR Sheet, and it is a one-stop place where you can physically see if medication has been administered or refused. Then it is also a way of seeing if staff have forgotten to sign for medication, but then that is another part of the process where we would do our audit of counting tablets to make sure we have got the right numbers to make sure it has been administered properly. MAR Sheets will be different from each pharmacy - there isn't a standardised model that is there. Some of the actual initialling would be different per pharmacy, so it always boils down to what the pharmacy provides, and then also what the organisational policy and procedure is regarding administration of medication. What their actual process and procedures is if there is a refusal, what is their process. Do the staff phone the doctor or is it the team leader, the manager who may be on shift, or is it the on-call manager who needs to do that. So you have to follow the process and it is always down to policy and procedure. Any time there are any issues with medication, there should be some sort of system in place which would be policy on, if there was a refusal, how many times can someone refuse before it becomes a major issue and then they have to report it further up the line. Anytime if someone is taken ill because of taking medication, is it because it is a bad batch of medication, or is it just because they are ill at the current time. Always, always err on the side of what the policy says, let's look at the procedure and make sure we are doing everything in line with what that is. Not all MAR Sheets are the same so we have to go with what the pharmacy provides, but as long as it's in line with our policy procedure, we are okay. As it is called the Medication Administration Record, it means that I am the person who has administered the medication, and at no point am I to sign for anybody else who has administered medication. It is something called administration or readmission or a represcribing, where a pharmacist has prescribed it and put it in the blister pack, I have then popped it in the pot, therefore it is my responsibility to give that medication. I can't then hand it off to somebody else to then administer because, how would they know that I have put the right medication in there. So that is the whole idea is, it is whoever gives the medication must sign the MAR Sheet. If a service user is self-administering, that means they put the pill in the pot, they take it themselves, I can't sign that sheet, because the sheet is then saying that I administered yeh? So it has to be the person that administered the medication that signed it, you can't give it to another staff to give and then sign it, and that if the person self-administers, then there is a code: "S", for self-administration. So that is what we would put in the box. Once you sign it when you issue it, you are saying you have given the medication, and this can be an issue because there are safeguardings that could potentially happen from it.
Understanding the Medication Administration Record (MAR) Sheet
Importance of the MAR Sheet
Key Information: How the MAR Sheet supports medication administration.
The Medication Administration Record (MAR) Sheet is essential for managing medication effectively. It serves as a comprehensive document that ensures safe administration.
Components of the MAR Sheet
Essential Details: What information is included on the MAR Sheet?
- Person's name, date of birth, and any allergies.
- GP's name and contact details for medical oversight.
- Structured as a 28-day cycle, divided into weekly sections (Monday to Sunday).
- Details align with the prescription received from the GP.
Each medication entry specifies the name (e.g., Diazepam), dosage strength (e.g., 20 milligrams), and form (tablet, capsule, liquid). It also includes important usage instructions, such as warnings about alcohol consumption or operating heavy machinery.