Download MARs

Calculate with Confidence
5th edition
Gray Morris
Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
Medication Administration
Records and
Drug Distribution Systems
Unit Three: Chapter 12
Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
MARs and Distribution Systems:
Objectives
After reviewing this chapter, you should be
able to:
1. Identify the necessary information that must
be transcribed to a Medication Administration
Record (MAR)
2. Read an MAR and identify medications that
are given on a routine basis, including the
name of the medication, the dosage, the
route, and the time
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MARs and Distribution Systems:
Objectives (cont’d)
Transcribe medication orders to a MAR
4. Identify various drug distribution systems
3.
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Documentation: 6th “Right”
SPECIAL CONSIDERATIONS to avoid errors:
 TRANSCRIBE CAREFULLY
 Document AFTER med administration
 Document accurately
 Document legibly
 Document timely
 MAR is a legal record
 MAR is verified against orders daily
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Essential Information on a MAR
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Client information
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Dates (when written, start and stop)
Medication information
Time of administration
Initials (transcriber, person giving med)
Special instructions
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Name, DOB, medical record #, ALLERGIES
Data such as BP, “Hold if…,” etc.
Legends—describe abbreviations
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Documentation of Meds
Administered
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Complete schedule written
Initialed in appropriate area by giver
One-time doses
PRN doses (may be a different record)
Refused or held meds (special symbols)
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Figure 12-2 Transcription of medication orders to a medication administration record. (Used with
permission of St. Barnabas Hospital, Bronx, New York.)
Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
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Figure 12-2 Transcription of medication orders to a medication administration record. (Used with
permission of St. Barnabas Hospital, Bronx, New York.)
Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
9
Figure 12-2 Transcription of medication orders to a medication administration record. (Used with
permission of St. Barnabas Hospital, Bronx, New York.)
Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
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Use of Computers

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Handwritten transcription and documentation
are among most common causes of med
errors
Goal
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Elimination of errors
Electronic record keeping
Systems utilize
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CPOE (computer prescriber order entry)
Electronic MAR
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Medication Distribution Systems
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Unit Dose
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Computer-Controlled Dispensing
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Prepared daily and sent to unit
Not available for all products
Automated dispensing system (ADS)—60% of
hospitals
Detailed transaction records
Linked to pharmacy dispensing system
Bar-Code Medication Delivery

Studies show errors reduced by 65%-86%
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Figure 12-3 Unit-dose cabinet. (From Clayton
BD, Stock YN, Harroun RD: Basic pharmacology
for nurses, ed. 14, St. Louis, 2007, Mosby.)
Figure 12-4 Pyxis Med Station.
(From Clayton BD, Stock YN, Harroun
RD: Basic pharmacology for nurses,
ed. 14, St. Louis, 2007, Mosby.)
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Figure 12-5 Bar code for unit drug dose. (From
Kee JL, Marshall SM: Clinical calculations: with
applications to general and specialty areas, ed. 6, St.
Louis, 2009, Saunders.)
Figure 12-6 Bar-code reader. (From Kee
JL, Marshall SM: Clinical calculations:
with applications to general and specialty
areas, ed. 6, St. Louis, 2009, Saunders.)
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Advantages and Disadvantages
of Technology
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Advantages
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Improves accuracy and efficiency
Safeguards the 6 rights (especially Bar-Code)
Records can be readily accessed
Disadvantages
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Human component in use of system
Human component in relying solely on system
Requires extensive up-front design and use
planning
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Scheduling Times (Table 12-1)
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