Two seperate medication administration records for one patient?

[johnjrb]

Has anybody ever heard of having two MAR's for one patient? On our unit we have an electronic MAR and when medications are entered we have to use the providers name who ordered the medications. The problems is on the evenings and weekends the providers we have on call are not in our electronic MAR so the medications cannot be entered so we use a handwritten MAR's until our regular providers can review the medications and determine if they are going to go on the electronic MAR. Our providers work Monday through Friday 7:00am - 10:30pm so if a medication is ordered Friday night we would be using the handwritten MAR for that specific medication until Monday morning. This seems like it is just asking for a med error, and I really do not like it. What do you think? Also the providers we have on call change so often that they do not want to give them the training so they can be put in the electronic MAR.

[ktwlpn, LPN]

We are still writing on stone tablets at the LTC where I work so I am not really familiar with those systems but this does sound like a bad set-up .When our regular med staff are off and being covered by docs that we don't know well we write both doc's names on the order because the covering docs don't come to the facility to sign the verbal orders. The regular staff docs have to sign them all. Can't you enter the new orders under the name of the doc being covered? And enter every order electronically-it can easily be d/c'd if the resident's regular doc does not concur with the order. That sounds safer to me then writing it out on a separate MAR. Entering it electronically right away gets it to your pharmacy's database,too.They pick up the allergies or contra-indications that we can sometimes miss-especially important when the ordering doc is not familiar with the resident and maybe not listening closely to the resident's history...You have alot of issues here-I think you should stress your patient safety concerns to management.