Question about the MAR

We write the blood sugar and also the amount/type of insulin given on our MAR, as well as document it on the diabetic flow sheet. I guess if you are going to give the insulin they need to see justification about why it was given. Different patients are on different scales, at least where I work.

Beth

At the LTC facility I work at, we have a place on the MAR to write the results of blood sugar checks. I was wondering if they are suppose to go on the MAR??? I got wrote up for not writing one blood sugar result on the MAR. But, I thought that the MAR meant medication administration record? Does it not?

Yes, it does mean medication administration record, but depending on what the blood sugar is medication is give for too high and low. I think that writing it on the MAR lets all the other nurses know what the patient has been running and if they have received any medication. A pt. could have had a low BS (50) at 0600. The nurse working 11-7 shift does not tell you in report. you find you pt. unresponsive. All you have to do is look back in your MAR and see what there BS was that morning, besides going to find the chart and looking at the flow sheet. I think having it on the MAR is a great idea.

Any glucoscans, B/P's, and pulse go on the MAR if they will affect the amount of medication given such as holding a med or giving a sliding scale. LTC nurses are giving so many medications they need these results immediately. If I'm passing meds and I notice a that a residents glucoscan has been high for the last 3 days I can then call the MD for new orders. Having the results on the MAR enables the nurse to not have to hunt and search for results and to notice trends right away. Hope this helps.

The MAR is not only for documenting the giving of medication but also for recording any criteria that determine the amount of the med and whether or not it should be given.

Blood glucose levels are used to determine sliding scale amounts of insuling. Based on the level, say 72, the patient should have their insulin held.

This is also true of meds that affect blood pressure. You'll see orders like 1000 mg. methyldopa PO BID. Hold if BP

Think of it this way. You would write a patients blood pressure down as reason for giving or not giving a BP med. You do the same for Blood sugar. Because you are reinforcing your reasoning for holding or giving a med....

At the LTC facility I work at, we have a place on the MAR to write the results of blood sugar checks. I was wondering if they are suppose to go on the MAR??? I got wrote up for not writing one blood sugar result on the MAR. But, I thought that the MAR meant medication administration record? Does it not?

Just curious, I'm LTC too, were else do you thing they should go? In my experience, the more places you have to document, the higher the chance of them not getting documented.

This is exactly why I dont think we should put blood sugars on a MAR then turn and put them on a Diabetic sheet , then next will have to put them somewhere else. Numbers get jumbled or forgotton and the next thing you are staring at is a write up because you have lost your extensive list of places to post every blood sugar.... Double , triple .... Quadtriple Charting:barf02:

Just curious, I'm LTC too, were else do you thing they should go? In my experience, the more places you have to document, the higher the chance of them not getting documented.

Just curious, I'm LTC too, were else do you thing they should go? In my experience, the more places you have to document, the higher the chance of them not getting documented.

The only places we document BP and BS is on the MAR and on the flow sheet. I see exactly what you're saying about the more places you have to document on.

We just place them on the MAR. We have another sheet that is a weekly glucose record that gets filled out by the 11-7 nurse adn faxed to the MDs weekly. Previously we had this sheet in the MAR and we were resposible to put the RBG on it at the time we took it, what was done and if we needed further orders. Nurses weren't doing this, do we went to the 11-7 nurse doing this weekly instead.

Just remember, the state loves empy blanks.