Blanks on MARS

[AngelsWings09]

I have a situation and need some good unbiased opinions. When it come to your MARS and TARS, how strict is your facility when it comes to the end of the month and blanks have been left. Are you allowed to go back at the end of the month and fill in where you have missed? What does the nursing protocol say about this. If you have missed, and did not catch them, do you get wrote up over the blanks? If you do go back and fill in your missed spaces, do you consider this fraud and illegal? I'm just wondering because our facility has been writing up

everyone and a few have gotten suspensions because of this. I do realize that if it has not written it has not been done, but we are human, and at tims you do have to drop everything and attend to a situation that may arise, and lose your place when you come back, expecially if the situation is one that rattles you, such as a code or a bad fall.

[kellykelly]

Not sure about end-of-the-month type thing, are you talking LTC? We have emars now instead of paper mars but even then, nobody would be allowed to leave a blank space. If the nurse before you left something blank they are asked to fix it before they leave, or if they've already left before you discovered it, they get a phone call asking whether they gave it and you can chart that it was given at such-and-such time by whatever nurse. It doesn't chart under their name, just that you are saying so and so gave it, so if there was ever a legal issue they can tell who did the actual charting of the med.

[suni, BSN, RN]

we are ;not allowed to let blanks, we try to call the nurse who left it blank to see if it was given and if we can not reach her we are required to do an incident report.

[LHH1996]

From an MDS nurse stand point..i have found that when certain meds aren't signed off i cant count them...(some meds you have to count how many days the resident had them) IF i don't count it because someone forgot to sign it off..and then later it is signed off, then it looks like my MDs isn't accurate..

on the other hand..we do try to make sure the nurse signs off as soon as possible..we are all human. Some places put in an audit system to check it weekly or biweekly and leave notes for the particular nurse.

[canoehead, BSN, RN]

This is related to the thread we have on check off assessments (lying nurses is the title). A month later how do you know if you gave the drug or not? How many people would just sign it off because they want to avoid the hassle?

[CathyLew]

Maybe you can be proactive with this, and get the help of your fellow nurses. Watch each other's backs. Make it a point to point out blanks before a long time goes by. If you don't want to get called at home about this, talk with the other nurses, and leave notes in each other's mailboxes. Or in report, both shifts go thrugh the MAR, and point out blanks before the other nurse goes home.

Don't leave this up to management. If they see you don't care enough to check each others work, then they may think that write ups are the way to go.

and management will be happy to have one less thing to worry about not getting done.

[caliotter3]

In LTC, our night shift supervisors would audit the MARS and make a list of discrepancies for the nurses to fix. Everyone tried not to get their name on this list. Don't believe anyone ever got chewed out about it though, unless they were lazy and didn't fix their mistakes.

[BradleyRN]

Signing the MAR is just as fundamental as giving the drug. If nurses fail to do so, then they should be written up, as it indicates that the nurse isnt going by the MAR, wont know of any changes in meds, or of missing meds on the cart.

[AngelsWings09]

Update ....Yesterday I got fired. Reason was that I went back thru my MARS at the end of the month to see if I had missed any spaces and initialled them

Told this was documentation fraud. Yet, in an inservice a few months ago, we were told to review our MARS at the end of the month and initial where we had missed.

[CoffeeRTC, BSN, RN]

I'm willing to bet that there was no policy in place nor would there be that states you should go back at the end of the month to check and sign. How many holes are we talking about? Sounds like you were probably set up?

Yes...I get busy just like everyone else and miss a few blanks. Checking my books is the last thing I do before I leave. Takes about 5 minutes for 26 or so residents.

[caliotter3]

Somebody definitely had it in for you AngelsWings. Sorry to hear you got fired, but I have to think that you should have taken your cue from the fact that people were getting suspensions for this and tightened up your actions. No place I have ever worked at would have done this, but if they started suspending people, then I would take notice and act accordingly. Good luck finding a new job.

[systoly]

Blanks on MARs are a serious problem. If, for instance, you have to call an on-call Dr. for elevated B/P, BG, HR, or any number of reasons, you need to know what meds the patient has had. While nobody is perfect, there's usually a pattern. It's usually the same people who leave blanks. So, if you have a coworker who tends to do this, work with them. Discuss the situation and try to come up with solutions. Remind each other, make a check list, whatever might work. Disciplinary action doesn't solve anything it just adds more negatives. At one point I was notorious for not totaling my I/Os at the end of the shift, so I asked my coworkers to help. They didn't mind, I got teased over it, but in the end the task was completed without negative reinforcement.