Medication Administration

The Medication Administration function is designed to give agencies a method to track and record administered medications as designated within Patient Medications charting. Patients whose medication list contains medications checked with Show in MAR or were added using the Add to MAR button will display in the Medication Administration List.

As with Patient Medications and Patient Allergies, users enter the Medication Administration screen using the Navigate to drop down. The screen opens to display all applicable patients who linked to medication administration “events.” These patients and the related events are filtered and displayed as explained below.



Settings to Control Medication Administration

The following tables allow agencies to control and/or customize standard options for administration charting. These tables are located under Administration>System>Agency Tables (J-Q):

The following settings located under Administration>System>Agency Settings>Medication Administration control how events timed and control the tracking of needed action.



Medication Administrations Events In General

The medication administrative action is referred to as a medication administration “event.” The items below are specific labels for the status of some events that users will see:



Views and Navigation

Below is a basic overview of what users see within the Medication Administration function. The screen options displayed depend on the option chosen to view - Meds, Schedule, or Detail. Use the breadcrumb links in the top left of the display to help navigate back to a previous view.

Primary Views Overview

There are three primary views to navigate to within Medication Administration. You can switch between these views by clicking the button for each in the top right. Each view serves a different purpose:


Medication Administration Color Code Descriptions

Within Medication Administration, certain color coding tools are utilized for easy reference to the status of various events. Below are the colors used and what they are designed to signify within prescribed area:

Color Meaning
Grey Schedule/Detail view - Medication Administration Event Status is Scheduled.
Meds/Detail View - Medication Priority other than PRN
Dark Grey Schedule/Detail view - Medication Administration Event Status is Scheduled and is currently within the window of administration (upcoming, overdue).
Light Green Schedule/Detail view - Medication Administration Event Status is Given.
Light Blue Schedule/Detail view - Medication Administration Event Status is Not Given.
Purple Schedule/Detail view - Medication Administration Event Status is In Progress.
Orange Meds/Detail View - Medication Priority is PRN.
Red Medication administration event status is Missed.
Light Green Schedule/Detail view - Medication Administration Event Status is Administered Early (Adm'd Early).

Meds View Highlighting

The Meds View also displays color coded row highlighting to reflect differences in the medication’s status. Those differences are as follows:

Color Meaning
Pink Med entry is highlighted to indicate the medication has a Missed event since the last completed administration.
Grey Med entry is highlighted to indicate the medication is inactive and therefore you are unable to administer for current date/time (e.g., medication is discontinued, but is still available for edits to events prior to the discontinue date.

Medication Timing Color Codes

To signal the status of a med and the timing related to explicit timing events, color coding is designed to share the status of a medication as follows:

Color Meaning
Red Med Detail: Missed the timed event / When administering if outside the scheduled time
Dark Grey Overdue/Upcoming
White Within the scheduled time period / When administering if within the scheduled time
Grey Scheduled

Patient List

All patients available for medication administration are displayed on the left side. This list is present regardless of the current view selected (i.e., Meds, Schedule, or Detail). Within the Meds view, you may only select one patient. One or more patients can be selected to view medications and/or administration events related to the patient(s) within the Schedule and Detail views.

When navigating between views, note that the Meds view will always deselect all patients currently selected, then select the first patient selected, or the first in the list, meaning the patients will need to be selected again upon navigating to a view that allows multiple patient selection (Schedule, Detail).


Filters

Filters allow you to control the content displayed by drilling down to the information you want to see. Open the Filter using the filter icon in the top right. You can filter content within any primary view (Meds, Schedule, Detail). The selections made are retained when switching between views. However, not all filters are available in each primary view and are, in essence, ignored when viewing content for that view, whether they have been selected in another view or not. The filter criteria options include:



Primary Views in Detail

Meds View

The Meds view can best be described as a display of the patient’s medication administration record. Here are the key components and important details related to this view:


Schedule View

The Schedule view provides a calendar view of the administration events with the ability to filter over a designated period of time, while providing the ability to quickly select all events for a specific time, or individually. Here are the key components and important details related to this view:


Detail View

A listing of all medication administration events occurring during the time window specified within the filters. Here are the key components and important details related to this view:



Medication Detail Summary Screen

Each View option (Meds, Schedule, or Details), allows users to access important information for selected meds. To access this information, click a medication name anywhere it is displayed as an underlined hyperlink within the Medication column. The information available includes alerts regarding administration status, specifics about the medications, and next occurrence details. Actions available: Admin Now, Schedule, Reschedule Next, Med History



Administration Process

Documenting Medication Administration Details

Within the primary views, users are able to complete the process of charting Medication Administration Events manually one medication at a time using the Admin Now button or in bulk with the Administer List compiled using the Administer + tool. These functions are designed to give clinicians the ability to chart administration events as described further later in these notes. Primarily, these functions provide users the ability to formally assign a status to the medication event to include: Given, Not Given, or In Progress. Specifically, these labels can be described as:

To access the medication administration charting screens, users need to use either of the two methods described below:


Admin Now

The Admin Now button is available within the Med, Schedule, Detail views. If clicked in conjunction with a selected medication, this screen allows you to immediately document all of the relevant details related to administering the selected med. If enabled for a particular medication, the selection of a generic substitution is allowed. Among the data captured, users may note patient reactions, comments, and a variety of other important fields. This action is only available when one medication or event is selected.


Administer List

Think of the Administer List as a replacement to a med cart, where you can add medication administration events to a list, then play (or cycle) through each administration event in the order you wish to administer them in. If you ever intend to administer more than one medication, then adding events to the Administer List is a much quicker option than using the Admin Now action on each event.

From any of the primary views (Meds, Schedule, Detail), you are able to select multiple medications/event and add them to the Administer List by using the Administer + option located at the top of the view. Note that not all (medication) administration events may be added to the Administer List for various reasons, such as the event has already been changed to Given or Not Given.

Admin Now performed on any administration event or medication listed will remove that item from the administration list if it exists there to allow the administration of the single event.

To see the list of medication administration events added to the Administer List click the text or the play action. Either will take you directly to the list of administration events to review before proceeding with administration. This view is called the Medication Administration Session.


Administration of Multiple Meds Using the Administer List

When administering multiple medications, an administration session is created to provide the ability to view the list of all medications to administer, as well as their current status (in the far right column). Once an administration event is initiated, the breadcrumbs in the top left provide a link to go back to the Medication Administration Session.

Administration events may be removed at any time from the Medication Administration Session view by selecting each, then clicking the - action.

All administration events displayed must be completed to save the session. Note that the use of the - action to remove multiple events may come in handy to save all other completed events quickly.

Access to the Medication Detail view is available by clicking the medication name in any row.


Beginning Administration

The play action begins the administration session starting with the first Medication Administration Event in the list. As each event is completed or started (e.g., In Progress), the next event in the list will be presented for administration.

Alternatively, the cycle of Medication Administration Events can begin by clicking a row in any location aside from the checkbox, or medication name. Once the event is completed, the next medication in the list will appear for administration.



Medication Administration Event Charting

Using Admin Now or the Administer List, the content and options available within the event charting screen are explained below:

Event Field Descriptions

All fields indicating a DE/DCS # are updated automatically in the patient record upon saving and are then accessible as part of the field history in Visit Charting via Patient Profile. IV fields are only available with the IV option checked. The IV checkbox will be checked automatically for medications selected from the FDB database that can be identified as intravenous/infusion.

Name DE/DCS # Description
Administered By User that performed the medication administration.
Administration Date Date the medication was administered on.
Administration Time Time the medication was administered at.
Amount Given Total amount/quantity of medication given during administration. This field should be used to denote the volume when administering an IV medication.
Comment Record comments about the medication administration. (Max. 250 characters)
Error Reason Reason the medication administration was charted in error. This field is required when the Error action is applied to a medication administration event.
Expiration Date Date the medication expires.
(IV) Drip Rate The drip rate of the infusion.
(IV) Drop Factor The drop factor of the infusion.
(IV) Flow Rate 102046 The flow rate of the infusion.
(IV) Site Appearance 101152, 101182 The appearance of the Site Given for the IV.
(IV) Size 102132 The size of the IV.
(IV) Type 102131 The type of IV.
Lot # Lot number on the medication administered.
Med Given Medication administered to the patient. This field is editable if Allow substitution for generic? is set to Yes on the medication within Patient Medications.
Not Given Reason The reason the medication was not given to the patient. Values are populated based on entries in the Med Administration Not Given Reason table.
Patient Reaction The patient's reaction to the medication. Values are populated based on entries in the Med Administration Patient Reaction table.
PRN Reason The reason for administering PRN priority medication. Values are populated based on entries in the Med Administration PRN Reason table.
Site Given 102133 Location the medication was administered to.
Note: This field will only update the corresponding DE/DCS # when the IV option is selected.
Start Time Time at which the administration event started.
Stop Time Time at which the administration event stopped.
Total Time Total time the medication was administered for.
Witnesses List of all witnesses of the medication administration. Please note that the source of options for this field is the Employee Table, so only those individuals with an active account in the Employee Table are displayed.


Events Administered Early

If a missed or scheduled event is selected from the Schedule or Detail view, and it is administered before its early-administration threshold, then a new administration is created, but the original event's status is set to Adm'd Early, and becomes read only in the calendar. This provides an indicator to users viewing the schedule later that the administration was already administered.



Missed Events

The Error action is only available for events with a status of Given or Not Given. If a missed event should be noted as an error, change the event to Not Given, then you may optionally apply the Error action. Use of the Not Given reason Event Expired is suggested. Note: the Agency Settings described in the beginning of these instructions also provide a method to manage these missed events.



Action Button Reference

In order to execute actions related to the management of the administration events, each view has certain buttons available. The accessibility of these buttons and a general overview of the options are described below.

Action Views
Admin Now Med, Schedule, Detail, Med Detail - Administer the medication or event at its specific date/time. This action is only available when one medication or event is selected.
Schedule Med, Med Detail - Schedule an administration event for a medication to occur at a specific date/time.
Reschedule Next Med, Med Detail - Reschedule the next administration event for the medication to occur at a different date/time.
Reschedule Schedule, Detail - Reschedule an administration event for another date/time.
Edit Schedule, Detail - Edit an administration event occurrence. Edit is only available for events that are completed
Error Schedule, Detail - Change the administration event occurrence to Error. An Error Reason is required.
Med History Med, Med Detail - View the medication history of the medication(s) selected
Event History Schedule, Detail - View the history of event(s) selected.
Administer List Med, Schedule, Detail, Med Detail - Located at the top of the screen. Click the Administer hyperlink to view the list and the + button to add selected medications to the Administer “cart” and the ► (Play) option to cycle through the Administer List and take action as described above.