TABLE OF CONTENTS. MAR Activity. Pharmacy Labels...1. MAR Review Practice Activity...5. MAR Practice Activity Answer Key...9

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3 TABLE OF CONTENTS MAR Activity Pharmacy Labels...1 MAR Review Practice Activity...5 MAR Practice Activity Answer Key...9 MAR Review Audit Practice Activity Answer Key... 13

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5 PHARMACY LABELS Page 1

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7 MAR Review Practice Activity Pharmacy Labels Pharmacy Label 1 Local Drugstore, Inc. DEA: PA Main Street RPH: FXO Anytown, PA Original script date: /1/2003 RX Date filled: 07/1/2003 Freddy Smith 238 Dogwood Drive Anytown, PA Take 1 tablet by mouth once a day. Lipitor 20 mg QTY: 30 tablets MFG Drugs International, Inc. Refills: 3 Burns, Howard MD Drug expiration: 8/10/2005 Pharmacy Label 2 Local Drugstore, Inc. DEA: PA Main Street RPH: FXO Anytown, PA Original script date: /1/2003 RX Date filled: 07/1/2003 Freddy Smith 238 Dogwood Drive Anytown, PA Take 1 tablet by mouth in the morning and afternoon and 2 tablets before bedtime. Divalproex sodium 250 mg QTY: 120 tablets MFG Drugs International, Inc. Refills: 3 Burns, Howard MD Drug expiration: 8/10/2005 Page 3

8 Pharmacy Label 3 Local Drugstore, Inc. DEA: PA Main Street RPH: FXO Anytown, PA Original script date: /10/2003 RX Date filled: 07/10/2003 Freddy Smith 238 Dogwood Drive Anytown, PA Take 2 tablets by mouth once a day. Lipitor 20 mg QTY: 60 tablets MFG Drugs International, Inc. Refills: 3 Burns, Howard MD Drug expiration: 8/10/2005 Pharmacy Label 4 Local Drugstore, Inc. DEA: PA Main Street RPH: FXO Anytown, PA Original script date: /10/2003 RX Date filled: 07/10/2003 Freddy Smith 238 Dogwood Drive Anytown, PA Take 1 tablets by mouth two times a day. Hydrochlorothiazide 50 mg QTY: 60 tablets MFG Drugs International, Inc. Refills: 3 Burns, Howard MD Drug expiration: 8/10/2005 Page 4

9 MAR REVIEW PRACTICE ACTIVITY Page 5

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11 Medication Administration Record (MAR) MAR Review Practice Activity for Brenda Boyer on 7/15/2003 MEDICATION HOUR Lipitor 20 mg am SC FG FG FG FG FG SC SC JC BB BB BB BB Take 1 2 tablet by mouth once a day. pm AC JM JM V JM JM AC AC JM JM JM JM JM AC 7/10/03 Dose changed to 2 tabs daily. BB Divalproex sodium 250 mg Take tablet by mouth in the morning and afternoon and 2 tablets before bedtime Hydrochlorothiazide 50 mg Take 1 tablet twice. 8 am SC FG FG FG FG FG SC SC JC BB BB BB BB SC 4 pm SC FG FG FG FG FG SC SC BB BB BB BB O SC 8 pm AC JM JM V JM JM AC AC JM JM JM JM JM AC 8 am BB BB BB SC 8 pm JM JM JM JM AC Propranolol HCL 40 mg Take 2 tablets by mouth two times a day. 8 am SC FG FG FG FG FG SC SC JC BB BB BB BB SC 8 pm AC JM JM V JM JM AC AC JM JM JM JM JM AC Dates of administration from: July 1, 2003 to July 31, 2003 PHYSICIAN(S): Howard Burns, Mary Jacobs ALLERGIES Penicillin DIAGNOSES: Migraine headaches, high cholesterol, high blood pressure, bipolar disorder NAME: DOB 12/1/1965 ID NUMBER: Page 7

12 Medication Administration Record (MAR) - Back DATE TIME GIVEN MEDICATION & DOSE ROUTE REASON RESPONSE INITIALS INITIALS ADMINISTRATOR S SIGNATURE INITIALS ADMINISTRATOR S SIGNATURE TG Tanya Green FG Foster Grant SC Sheldon Collins JM Jim Morgan Brenda Boyer GD Glenda Dopson AC Amanda Coulter Page 8

13 MAR REVIEW PRACTICE ACTIVITY ANSWER KEY Page 9

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15 Medication Administration Record (MAR) MAR Review Practice Activity for Brenda Boyer on 7/15/2003 Answer Key MEDICATION HOUR Lipitor 20 mg am SC FG FG FG FG FG SC SC JC BB BB BB BB Take 1 2 tablet by mouth once a day. pm AC JM JM V JM JM AC AC JM JM JM JM JM AC 7/10/03 Dose changed to 2 tabs daily. BB Divalproex sodium 250 mg Take [dose] tablet by mouth in the morning and afternoon and 2 tablets before bedtime Hydrochlorothiazide 50 mg Take 1 tablet [route] twice. 8 am SC FG FG FG FG FG SC SC JC BB BB BB BB SC 4 pm SC FG FG FG FG FG SC SC BB BB BB BB O SC 8 pm AC JM JM V JM JM AC AC JM JM JM JM JM AC 8 am BB BB BB SC 8 pm JM JM JM JM AC Propranolol HCL 40 mg Take 2 tablets by mouth two times a day. 8 am SC FG FG FG FG FG SC SC JC BB BB BB BB SC 8 pm AC JM JM V JM JM AC AC JM JM JM JM JM AC Dates of administration from: July 1, 2003 to July 31, 2003 PHYSICIAN(S): Howard Burns, Mary Jacobs ALLERGIES Penicillin DIAGNOSES: Migraine headaches, high cholesterol, high blood pressure, bipolar disorder NAME: DOB 12/1/1965 ID NUMBER: Page 11

16 Medication Administration Record (MAR) - Back DATE TIME GIVEN MEDICATION & DOSE ROUTE REASON RESPONSE INITIALS INITIALS ADMINISTRATOR S SIGNATURE INITIALS ADMINISTRATOR S SIGNATURE TG Tanya Green FG Foster Grant SC Sheldon Collins JM Jim Morgan Brenda Boyer GD Glenda Dopson AC Amanda Coulter Page 12

17 MAR REVIEW AUDIT PRACTICE ACTIVITY ANSWER KEY Page 13

18 Page 14 PA DPW MEDICATION ADMINISTRATION PROGRAM

19 MAR REVIEW AUDIT PRACTICE ACTIVITY ANSWER KEY PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE MEDICATION ADMINISTRATION PROGRAM PRACTICUM OBSERVER S NAME: Trainers will use the checklist below to document the Practicum Observer s performance on the task of reviewing MARs for the Annual Practicum. The first two columns provide the information for the trainer to complete their own review of the MAR reviewed by the Practicum Observer. The trainer indicates the number of errors found for each item in the # of Errors Trainer Found column. Then, trainers compare the Practicum Observer s MAR Review Checklist to the Trainer Review column. In the # of Errors PO Found column, the trainer indicates the number of errors that the Practicum Observer correctly identified for that item, i.e. those that match the errors found by the trainer. In the # of Errors Not Errors PO Found column, the trainer indicates the number of errors the Practicum Observer identified that are not errors. Indicate in the Comments column any discrepancies between the trainer and Practicum Observer review. TRAINER REVIEW DATE OF REVIEW/AUDIT 7/15/2003 EMPLOYEE NAME FROM MAR REVIEWED Brenda Boyer NAME ON MAR Freddy Smith MONTH/YEAR OF MAR REVIEWED (PREVIOUS AND CURRENT) July 2003/July There is a corresponding entry on the current MAR for each labeled medication container that matches the pharmacy label. 2. All general information is present (e.g. name, allergies, diagnoses, etc.) using the current MAR. 3. Initials and signature of the employee are present on the MAR or central record using the current MAR. If central record used, there is a copy of that record with the MAR. 4. All applicable date/time blocks are initialed correctly using the current MAR. # ERRORS TRAINER FOUND PASS FAIL X List each error found. Time for Lipitor must be specified, not just morning and night Time for Lipitor does not match - the pharmacy label and the description box say once a day, but the hour of administration box lists two times Dose is missing for the 8 am and 4 pm divalproex sodium 6 Route is missing for hydrochlorothiazide Time for hydrochlorothiazide does not match the label - two times a day vs. twice Propranolol is listed on the MAR but not present in the box of medications. PASS FAIL X List each error found. Mary Jacobs is listed as a physician, but is not listed on any of the pharmacy labels. 2 No name on the MAR. PASS FAIL X List each error found. Brenda Boyer signed, but did not initial the MAR. 1 PASS FAIL X List each error found. BB is missing for 8 am on 7/13 for Lipitor. It is clear that BB documented giving the other medication at 8 am on 7/13. # ERRORS PO FOUND # ERRORS NOT ERRORS PO FOUND COMMENTS AUGUST 2013 Page 1 of 2 1

20 MAR REVIEW AUDIT PRACTICE ACTIVITY ANSWER KEY PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE MEDICATION ADMINISTRATION PROGRAM PRACTICUM OBSERVER S NAME: USING A PREVIOUS MONTH S MAR 5. DISCONTINUATION OF A MEDICATION 6. NEW OR TIME LIMITED MEDICATION RESULTS P=PASS F=FAIL A=ABSENT F F TRAINER REVIEW LIST EACH ERROR FOUND ON THE MAR The Lipitor of 1 tablet daily should have been discontinued lining out the description and hour of administration boxes, line out the date and time boxes after the date of discontinuation, indicating in the note that it was discontinued. There should be a new entry for the order change of Lipitor to 2 tablets daily. The hydrochlorothiazide was added on 7/10/2003. The entry should include lining out the date and time boxes prior to the addition of the medication. # OF ERRORS TRAINER FOUND 7. PRN MEDICATION A 0 8. OMISSION OF A MEDICATION P Omission on 7/13/ A chart note and a report of a medication error should be included REFUSAL OF A MEDICATION A LATE ADMINISTRATION OF OMITTED OR REFUSED MEDICATION A ABSENCE OF A PERSON AT TIME Absence on 7/4/2003 at 8 pm - There should be P OF MEDICATION a corresponding note in the chart for this CONTROLLED SUBSTANCE AND COUNT A EXTERNAL DOCUMENTATION A 0 SCORING INSTRUCTIONS TOTAL (ADD # OF ERRORS FOR EACH COLUMN) 13 # OF ERRORS PO FOUND # OF ERRORS NOT ERRORS PO FOUND COMMENTS % OF ERRORS CORRECTLY IDENTIFIED BY PRACTICUM % OF ERRORS THAT ARE NOT ERRORS IDENTIFIED BY PASSED FAILED OBSERVER (MUST BE 75% OR GREATER TO PASS) PRACTICUM OBSERVER (MUST BE 25% OR LESS TO PASS) DATE OF FEEDBACK # OF ERRORS # OF ERRORS NOT TRAINER SIGNATURE PO FOUND ERRORS PO FOUND = x 100 = % = x 100 = % # OF ERRORS # OF ERRORS TRAINER FOUND 13 TRAINER FOUND 13 ATTACH A BLANK SHEET OF PAPER IF ADDITIONAL SPACE IS NEEDED FOR COMMENTS AUGUST 2013 Page 2 of 2 1 2