Using the MAR Chart

Before you use the MAR chart, you should record your name and initials in the careworker identification section – this is only needed once

You should only mark your initials on the MAR once the medicine has been administered & you have observed that it has been taken – for example, you have seen tablets being swallowed

If medicine is not administered when required, you should mark an ‘X‘ in place of your initials & record the reasons in the notes – for example, why it was declined or could not be given

If medicine is being left out to be taken later, prepare the medicine in a medicine cup or similar & mark an ‘A‘ on the MAR chart

If medicine is left out, this should be by prior agreement only and recorded in the care plan with a risk assessment

If you make an error on the MAR chart, you should circle the entry then record an explanation in the notes

You should never use an adjacent box to sign – if you make an error, you should explain that the medicine was administered in the notes

You should never write on the margin or any other part of the MAR chart

You should never sign the MAR chart retrospectively or for anyone other than yourself

Regular medicines should be be administered in a regular pattern – usually daily

When they need to be taken, a record should always be made on the MAR Chart

There is no need to record anything when they do not need to be taken – for example, where the medicine should be taken in the morning there is no need to mark an ‘X’ at the other visits

PRN medications have instructions for when they should be offered but are only taken to manage pain or other symptoms

When a PRN is not required, you should always mark an ‘X’ on the MAR Chart and record the reasons why in the notes

You need to refer to the PRN Protocol to understand what the medicine is for and how to understand when it is needed

You should record in the notes why the medication was needed and how you understood, or why it was not needed

For example ‘Paracetamol was administered because the Service User was in pain’, or ‘Paracetamol was not administered because the Service User was not in pain’

Some medicines are taken only once per week – for example, Alendronic Acid

Where these are to be administered, you should avoid entering ‘X’ for 6 days in advance and further since there may be an event which prevents administering on that day

Some medicines have instructions to take a variable dose – for example, ‘take one or two as required’ for Paracetamol

Where you mark your initials on the MAR Chart, you should also mark the number administered in the top-right corner of the box and circle it

When a new MAR chart starts, the new medication should always start with it

This is important because the medication might change from one MAR chart to the next

You should avoid using the old medication with the new MAR chart, or vice versa

Old medication should always be kept separately & returned to the pharmacy for disposal promptly

New medication is always started with a new MAR chart to allow tablets to be counted and compared to what has been recorded

MAR charts are always for 28 days, and pharmacies will always dispense exactly 28 days medication to allow for counting

This will sometimes require opening boxes to cut tablets out of the blister packs to make the exact number

When MAR charts are issued & medicines dispensed, pharmacies will always attach identical labels to the MAR chart and medicine boxes

When administering medicine, you should ensure that the labels are identical between the medicine boxes and the MAR chart

This should be in accordance with 5 of the ‘Six Rs’ of medication – i.e. right person, right medicine, right route, right dose, & right time

It is also important to match the dates on the labels, which indicate the day that the labels were produced

If there is a difference between the labels, you should inform your supervisor to prevent errors

There should never be a label on either a box or MAR chart without a corresponding label on the other

When the MAR chart date is in the red section you should inform your supervisor, who will arrange for more medication to be ordered

This is important, so do not assume someone else has already done it

Unless you have personally already raised the alert, it is best practice to do this whenever you are at a visit in the red dates