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Charting new territory: medication administration records and transcribing in district nursing services

02 December 2022
Volume 27 · Issue 12

Abstract

Community nurses are often requested to administer medicines. A medicines administration record (MAR) is usually used to demonstrate all medicines administered, withheld or declined. In Wales, district nursing teams have highlighted concerns about accessing MARs and have been seeking solutions, which includes transcription of medication, where an exact copy of previously prescribed medicines are made to enable their administration. To understand the types of medicines administered in district nursing teams and nurses' views on transcribing, an anonymised electronic survey was developed and shared with such teams across Wales. A total of 286 responses were received from Health Boards in Wales. The survey found 60% of nurses experienced difficulties in accessing MARs, particularly during the out of hours period. Overall, 77% of nurses supported transcribing as a possible solution. Further work is required to develop clear policies and training to support safe transcribing within district nursing services. This can be supported by providing access to the person's medical records.

In healthcare, medicines are the most common forms of intervention, helping to prevent, treat and manage many conditions or illnesses (National Institute for Health and Care Excellence (NICE), 2015). The rise in multimorbidity and polypharmacy, along with new models of delivering acute care, means that support services must be strengthened to ensure the safe and effective use of medicines in the community. Between 5 to 10% of all hospital admissions are medicines-related (Kongkaew et al, 2008; NICE, 2015), of which, two-thirds are potentially preventable (Howard et al, 2007).

NICE define medicines support as any support that enables a person to manage their medicines (NICE, 2017). In practical terms, this would include general support, such as reminding or prompting a person to take their medicine or supporting them with administration of medicines.

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