MARS

[jonnysangel777, LPN, LVN]

Can a nurse "prefill" the MAR with "FR" (Family Responsible for medication administration) for days that the nurse is not caring for the client?

[caliotter3]

When the nurse is not on duty or does not witness the PCG administering a med, the box is left blank.

[JustBeachyNurse, LPN]

No. That is fraud. If the nurse is not present the mar remains blank.

[smartnurse1982]

My agency has a key that reads:

P=Parent

Some nurses usually put P in the empty boxes to indicate parent gave it.

If the nurse witnessed the parent/caregiver giving the med,the key has "WP" for witnessed parent/caregiver giving meds.

I do not like doing that,because i did not see it.

There is one agency that has F for family,so they use that.

I personally do not write anything in the empty boxes because the client has 4 nursing agencies in the home,so why would i put "P"?

Most likely another agency nurse gave it.

[Elektra6, ASN, BSN, RN]

I leave it blank. One client's mother puts F for family in those spots. The agency is fine with either way.

[jonnysangel777, LPN, LVN]

I am very new to Private Duty Nursing and my director of nursing and former manager have been going back on forth on the MARS and have put me in the middle. I was told by my director and manger when I first started to have the nurses I manage to put FR (Family Responsible when the nurse is not present) and to not "pre-fill" the MARS on the days the nurses are not there and then my former manager is now telling the nurses they are to leave it blank and that its ok to "pre-fill" MARS. I am not sure what's right and what's not?

[caliotter3]

Putting anything but a blank box for administration times when an agency nurse is not present is just asking for trouble. Why does that one individual want to take the responsibility? Furthermore, who has the time to be documenting for times/situations when they aren't even at the home? Many nurses can't even keep up with the documentation that is due on their own shift, much less taking responsibility for what everyone else does or does not do.

[JustBeachyNurse, LPN]

You are asking for a citation by 1. Pre-filling out any document. What if on 10-1 you pre-fill the MAR for the month and the client gets hit by a bus and is hospitalized from 10-6 to 10-31 how do you explain documentation when the client was not even under your care?

how do you know the family administered the drug if you did not witness? Maybe they forgot? Maybe they tossed it in the garbage? Then a drug level for digoxin is done with abnormal levels. If the client was getting the medication as documented the level shouldn't be toxic or non-existent. Investigation occurs by APS because your client is a vulnerable senior possibly suffering from neglect. What's your excuse?

[jonnysangel777, LPN, LVN]

Thank you so much for all of your advice. I talked to the nurse who was struggling with this issue and with 2 people telling her 2 different things and she was actually going to write to the board of nursing and see what they say as well as the JCAHO.

[JustBeachyNurse, LPN]

Thank you so much for all of your advice. I talked to the nurse who was struggling with this issue and with 2 people telling her 2 different things and she was actually going to write to the board of nursing and see what they say as well as the JCAHO.

JCAHO accredits facilities not private duty agencies. I'm sure the BoN would be thrilled to hear about falsifying records. (Not really)