NHS Borders drugs and therapeutics
Controlled stationery is used to support discharges from the BGH, primarily in ED and MAU, but across the site.
Controlled stationery will be available from Central Stores.
Emergency Medicines Administration (MAR) Chart - NHS Borders SOP
Warning
Objectives
An emergency medicine administration chart to be used out of hours to enable discharge of patients back to a care home or care at home.
Out Of Hours medication changes on discharge for patients with a MAR chart
A Medicines Administration Record (MAR) chart is in place when a patient requires a support worker to administer their medicines in their own home or in their residential/care home. The support worker must sign for every medicine they administer, and they cannot administer a medicine which is not listed on a MAR.
As per Care Inspectorate: Guidance about medication personal plans, review, monitoring and record keeping in residential care services, care staff are permitted to transcribe medication changes against a clear instruction from a prescriber.
This process must be followed for OOH use where both the patient’s community pharmacy and the BGH pharmacy are closed, and the patient is being discharged.
Completion or modification of MAR charts or forms must only be carried out by a prescriber.
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Stopping medicines |
MAR chart with patient: Cross off the medicine(s) being stopped, and print name, sign and date on the MAR chart MAR chart not with patient: Complete the “change to MAR chart communication form” and send with patient on discharge to update carers on the changes to medicines for the MAR chart to be updated at home |
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Starting new medicines |
MAR chart with patient*: Supply medicine(s) and if there is space on the existing MAR chart write each new medicine and administration details on their MAR chart and print name, sign and date each addition. MAR chart not with patient, or no room on existing chart: Supply medicine(s) and a new Emergency MAR chart*. *Note directions for administration on the MAR chart MUST match the directions on the label of the medicine(s) being supplied e.g. take one tablet twice daily. If a non-urgent medicine is to be started, the patient can be supplied with an HBP prescription to be dispensed at a community pharmacy the next day and annotate “please supply MAR chart”. |
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Changes in dose/frequency of existing medicines |
MAR chart with patient: Cross off the medicine(s) with the old directions, and print name, sign and date on the MAR chart. Supply medicine(s) with the updated dose and directions on the label and if there is space on the existing MAR chart write each changed medicine and administration details on their MAR chart and print name, sign and date each addition*. MAR chart not with patient, or no room on existing chart: Complete the “change to MAR chart communication form” and send with patient on discharge to update carers on the changes to medicines for the MAR chart to be updated at home. Supply medicine(s) with the updated dose and directions on the label and a new Emergency MAR chart*. *Note directions for administration on the MAR chart MUST match the directions on the label of the medicine(s) being supplied e.g. take one tablet twice daily. |
For all scenarios ensure the discharge letter has the changes to medicines clearly documented for the GP and community pharmacy and include on the letter if an emergency MAR chart has been supplied.