Tips on Medication Administration
How do you know that you are giving appropriate medications at the correct time? Check your MAR
against the physician’s order using the 5 rights. Carefully check each MAR to see if any medications are
scheduled to be given and make sure the time on the MAR is accurate according to the physician's order.
What should be checked on ALL patients prior to administering any medications? Allergies
What is drug used for? ex) Lasix: diuretic used to "pull" excess fluid off from patient’s interstitial spaces
Why is YOUR pt getting this drug? ex) my patient has CHF, which means the hearts inability to pump
effectively causes fluid to “back-up” into the extremities and possibly the lungs
What are some important SE related to this drug? tinnitus, dehydration, hypokalemia, hypotension
What do you need to check & document on MAR prior to giving this medication? The most recent
potassium level & make sure blood pressure is not too low
Is the dose of this drug safe? Student should have looked this up & be aware that patient is on appropriate
dosage
When should you NOT give this medication? If: patient is allergic to medication or chemical in medication,
potassium is too low, blood pressure is too low, or patient is dehydrated according to labs. The MD should
be notified ASAP
What do you do as soon as you walk in the patient’s room? Wash hands
Then what? Turn on light & proceed to check 2 patient identifiers (name & DOB but NEVER room #).
What do you check these 2 patient identifiers against? Check what the patient says to the MAR to the
patients arm band (all of these should match)
How do you give the medications to the patients? Ask patient if they'd like to take one pill at a time or all at
once, make sure patient has water, & tell patient what medication is being given as well as what it is for (in
layman's terms).
What are some things that you need to remember? Sign the bottom of MAR, initial next to time when
medication is given, & document if medication is "held".
What do you need to do if you administer a PRN medication? Document time & initials on MAR and
document complaints & medication given in narrative nurse's notes.
Revised: Sp. 14, RP
Procedure for Transcription of Medication Orders to a MAR
1.
2.
3.
4.
Write in the patient identification information as available on the physician’s order form.
a.
Patient name
b.
Account number
c.
Room number
d.
Doctor’s name
e.
Diagnosis
f.
Allergies to food or drugs
Always start at the top of the physician’s order form when reading orders to be transcribed. Read each order to
determine if it is a medication order.
Write in the name of the drug, the dose, the time frequency, the route of administration, and the order date for
the drug. (Ex.) Pamelor 20mg twice daily po.
Write in the hours the drug will be administered based on the sample routine times in the hour column. Note
the corresponding shift column to determine the correct time frequency. (Ex.) 0900 or 2100.
Single, STAT, and PRN medications do not follow the routine times of administration. Frequency is determined by
the patients’ need for the drugs and is charted when given. (Ex.) Empco 30mg 1 tab prn for c/o pain q 4 hours.
Documentation of Medicine Administration
This sample MAR is a 24 hour chart form.
The nurse utilized the MAR to pour up medications to be administered at a particular time. After administering the
medications, the nurse charts the medicines as given, held, or refused by the patient.
Procedure for Charting Medicines Administered
1.
Note the date of the medication administration on the MAR.
2.
Slash the time given and write you initials. (Ex.) 9 MB
3.
Write your initials at the bottom of the page and your full name and title for identification of your initials.
(Ex.) MB Marie Billings, SLUSN
In the clinical area your title is SLUSN.
NOTE: If the drug is held or refused, circle the time and write your initials (Ex.) 9 MB
Document why the medication was not administered on the MAR.
Agency policy and procedure is always followed for medication administration and documentation. This is a
SAMPLE of one way of doing it.
Return Demonstration:
The essential of the Oral/Topical Medications Administration return demonstration includes validating the
transcribed medication orders from a physician’s order sheet on a MAR, preparing medications for a specified time;
administering medications; and recording on a MAR. In addition to the skill performance, critical behaviors identified
include the following:
1.
Review assigned medications and complete the Medication Research Form.
2.
Check the MAR and physician’s orders for consistency.
3.
Checks label 3 times when preparing medications.
4.
Uses the 5 rights before administering the drug.
5.
Checks patient ID before giving medications and ask about allergies (even if chart says NKA).
6.
Administers medications appropriately.
Revised: Sp. 14, RP
SLU
SCHOOL OF NURSING
MEDICATION ADMINISTRATION DOCUMENTATION
The nurse utilizes the MAR in administration of medicines on a schedule determined by the agency. Routine
medications are administered at times designated by the agency. This permits standardization for hours of
administration. A sample of routine medication times follows:
Frequency
Abbreviation
Time
Military Time
Daily
Twice a day
Daily
b.i.d.
9 am
9am & 9pm
0900
0900 & 2100
Three times a day
Four times a day
t.i.d.
q.i.d.
9am, 1pm, 5pm
9am, 1 pm,
5pm, 9pm
0900, 1300, 1700
0900, 1300,
1700, 2100
Bedtime
Before meals
h.s.
a.c.
9pm
7am, 11am, 4pm
2100
0700, 1100, 1600
After meals
p.c.
9am, 1pm, 6pm
0900, 1300, 1800
Every 2 hours
q 2hr
Usually begins at 6am and is scheduled
every 2 hrs thereafter
Every 4 hours
q 4hr
9am, 1 pm, 5pm,
9pm, 1 am, 5am
0900, 1300, 1700
2100, 0100, 0500
Every 6 hours
q 6hr
6am, 12N, 6pm, 12M
Every 8 hours
q 8hr
9am, 5pm, 1am
0600, 1200, 1800,
0000
0900, 1700, 0100
Look at the enclosed Physician’s Orders and pharmacist generated Medication Administration Record (MAR)
for Hope Full. See how the pharmacist documented the physician’s medication orders on a MAR. Check for accuracy.
Activities: Transcription of physician's orders to a MAR. Utilizing the above information and the Physician’s
Orders for Penny Cillin, correctly fill in the black MAR (Penny Cillin practice 1). There is also a completed MAR for
Penny Cillin. Compare it to the physician's orders and look for the mistakes (Penny Cillin practice 2). These are two
separate activities. Do not use the completed MAR to help you fill out the blank MAR as there are several errors.
Revised: Sp. 14, RP