Medication Administration Record: Implementation station of APIE stations is  a common pitfall in NMC OSCE. Many candidates have failed in OSCE only because of minor mistakes as well as occasional major ones in this station. In this article we will give a clear picture about Medication Administration Record (MAR) used in NMC OSCE  Implementation stations. Time duration for Implementation station is 15 minutes during which you will have to administer atleast a minimum of 2 medications.

Medication Administration Record (MAR)

Before starting, if you don’t know anything about Implementation station, please refer to our previous article onimplementation station prior reading this article.

Common pitfalls in Implementation station

• Administered a drug which the patient was allergic to
• Prescription was incomplete, still candidate administered that drug
• Weight was less than 50 KGs, candidate administered Tab. Paracetamol to patient.
• Candidates administered a wrong dose of medication to patient.
• Candidates have not identified patient before giving medicaiton
• Candidates forgot to check whether the patient had swallowed medication before signing
• Signed the chart prior to administration of medication
• Candidate forgot to mention the reason for not administering medication
• Candidate couldn’t get time to complete the station
• Candidate given wrong education about drug

Implementation Scenario

Following is a sample implementation scenario

Mrs. Jean Hope, DOB 19/6/68, Hosp. Number – F001001P has been transferred to ward from A and E with an acute onset of Asthma.

Please administer and document —– medications, safely and in accordance with NMC standards.

It is today and it is —-hrs

Admission Details section of MAR

Prescription Chart For – Name of Patient

Gender – Female/Male

Hospital Number –  ———-

Ward – ——-

Admission Date and Time – Today, Time

Known Allergies – _______

Type of reaction to allergic medication – _______

Signature and bleep numer of Doctor – _______

Codes if a medication is not administered

1. Patient is not present on ward

2. Omitted for a clinical reason

3. Medicine is not available

4. Patient refused Medication

5. Nausea or Vomiting

6. Illegible or Incomplete prescription or wrongly prescribed medication

7. Nil by Mouth

8. No IV Access

9. Other Reason – Please Document

Anthropometric Section of MAR

Ward Name – ____

Consultant Name – _____

Height of Patient – ____cms

Weight of Patient – ____Kgs

Oxygen Therapy Section

In this Target Oxygen saturation will be mentioned (Eg. >96%), Device used for Oxygen therapy (eg. Nasal Cannula), Flow (eg. 2 liters), Time started and signature (eg. your name if you are starting) as well as time discontinued and signature (eg. if target saturation is maintained at room air, you can disconnect the oxygen and write your name along with signature)

Please note, no prescription is complete without prescribers name, bleep number and start date.

Once only and stat medication Section

It will come with date prescribed, time due (eg. stat), Drug name, dose, route, prescribers signature and bleep, given by (nurse name) and time given (administered time)

PRN (As required Medication) Section of MAR

It will contain date prescribed, drug name, dose, route, instructions (frequency needed), prescriber signature and bleep, time given and given by (your name and time given)

Antimicrobials Section of MAR

A probiotic drink will be prescribed along with any antibiotic

Probiotic drink prescription will have date, dose, frequency, route, duration of medication (no of days planned) along with time to be given

Nurses will have a column to put the Date/Cod/Signature

Next drug is usually an antibiotic wilth start date and finish date along with dose, frequency, route, duration and time to be given.

Regular Medication Section of MAR

In this section bronchodilators, antipyretics, antihypertensives, antidiabetic medications etc will be prescribed

After regular medication section, next section would be Intravenous Fluid Therapy

Intravenous Fluid Therapy Section of MAR

In this Date prescribed along with fluid name, volume to be given, rate and time, prescriber name with bleep number, Batch number, commenced time, given by (Nurse name), checked by (other nurse name) as well as finishing time need to be entered

Non Administered Drugs Documentation Section

You need to put in details of date, time, drugs which you have not administered along with reason for not administering. You have to put your name and signature too.

Conclusion

Many candidates have failed OSCE Implementation station because of minor mistatkes. Be careful and practice more with MAR before attempting your OSCE.