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Pauline
Pauline, Doctor (MD)
Category: Health
Satisfied Customers: 8631
Experience:  Medical Doctor & Registered Pharmacist. Worked as Community pharmacist for 17 years.
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Where does the nmc stand on RN, nurses transcribing on to

Resolved Question:

Where does the nmc stand on RN, nurses transcribing on to the medical record sheets for drugs, should the Gp sign these records, within a set amount of time.

With controlled drugs, I have come across a situation where diamorphine was prescribed for a resident, for some reason the prescription has not been printed monthly on the MAR sheet, although it is still prescribed for the gentleman as needed. I know it cannot be given but my colleagues do not seem to understand what I am saying. Where would we stand if this was given but not written on the MAR sheet by the doctor, but transcribed onto the MAR sheet by the nurse?
Submitted: 6 years ago.
Category: Health
Expert:  Pauline replied 6 years ago.

Pauline :

The GP had already issued a valid prescription and in most cases for controlled drugs given orally then this is adequate. However my understanding is that the health visitors need a separate sheet for either syringe driver or sub cutaneous injections for 'prn' to allow them to administer the drug.

Pauline :

Are you a regular nurse working in a residential or care home?

JACUSTOMER-d92bm75g- :

yes, I am going to be deputy manager from Jan 3rd, and I need to ensure we are practising appropriately, and following the code of conduct

Pauline :

You will have a legally labelled box in your possession that will fall under medicines act and NMC guidelines to allow administration of the drug to the patient. However without a printed MAR or a countersigned handwritten MAR then you will have nothing to check this label against. So there is a potential for error for adminstering from a handwritten MAR, however in practice it is usual for the GP to sign on the next visit or to request the pharmacy sends out an appropriate MAR. If the pharmacy will not support you in this, then you should speak to their care services manager (assuming this is a chain).

Pauline :

It is more a breach of Standard operating procedures than Medicines Act however should there be any error, then this creates a difficult situation.

JACUSTOMER-d92bm75g- :

thank you i await for anymore information

Pauline :

I will see if there is anything available through RPSGB

Pauline :

I've been into the sites for regulation of pharmacy services, and the MAR seems to come under either Care Commision or Residential/Care home Best practice or Standard Operating procedures.

Pauline :

You should ring your legal department in NMC after the holiday, however from a legal standpoint as long as the documented handwritten MAR is written by the nurse directly from a doctor's authorisation (via labelled drug, discharge letter or prescription) then this should be adequate however any changes from that direction need to be signed by the GP in person.

Pauline :

Ideally a second (trained) member of staff or the care manager should double check the MAR against the documentation. This can be a fax if necessary.

JACUSTOMER-d92bm75g- :

Thank you very much , that was very helpful, and I will contact the nmc on tuesday as suggested

JACUSTOMER-d92bm75g- :

mrs frost

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