How to Mess Up a MARS in One Easy Lesson

How to Mess Up a MARS in One Easy Lesson

Author: Mark Parkinson BsPharm:  President  AFC-CE

Credit Hours 1 - Approximate time required: 60 min.

 

Educational Goal

Enable caregivers to properly fill out a Medication Administration Records Sheet.

Educational Objectives

• Present the most common errors of filling out the MARS in a sarcastically humorous way.

Procedure:

Read the course materials.  2. Click on exam portal [Take Exam].  3. If you have not done so yet fill in Register form (username must be the name you want on your CE certificate).  4. Log in  5. Take exam.  6. Click on [Show Results] when done and follow the instructions that appear.  7. A score of 70% or better is considered passing and a Certificate of Completion will be generated for your records.

Disclaimer

   The information presented in this activity is not meant to serve as a guideline for patient management. All procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this article should not be used by care providers without evaluation of their patients’ Doctor. Some conditions and possible contraindications may be of concern. All applicable manufacturers’ product information should be reviewed before use. The author and publisher of this continuing education program have made all reasonable efforts to ensure that all information contained herein is accurate in accordance with the latest available scientific knowledge at the time of acceptance for publication. Nutritional products discussed are not intended for the diagnosis, treatment, cure, or prevention of any disease.

 

How to Mess Up a MARS in One Easy Lesson

 

There are those who just don’t learn a lesson until they suffer through the consequences of making a mistake. Following instructions, understanding the underlining principle or cooperation is just not their style. One would think that doing things the right way, in the beginning, would be easier but nooo. They feel it would be much easier to be lazy and put much more effort into correcting mistakes later on. Apparently, they just don’t feel successful until they mess up, get caught by government inspectors, and are forced to correct something later on.

I don’t personally think that would be good but evidently, a large portion of caregivers think this way when it comes to filling out a Medication Administration Records Sheet, or MARS for short. They must feel this way because they keep making the same mistakes on the MARS over and over again. Why else would they not learn from the past and change their behaviors?

So to make you feel successful, I want to help you fail and put much more effort into managing your medication duties than you have to. Because seemingly it feels good to fail an inspection of their MARS. So I present to you for your learning pleasure “How to mess up a MARS in one easy lesson”.  I’m excited about this course because sarcasm is such a fun teaching method. 

Responsibility

Now if you want to be embarrassed and fail miserably (and who doesn't want that bundle of joy) then there is no better way than to leave everything for someone else to do. Responsibility, who needs it anyway. It’s not like you have agreed to be in charge of keeping track of the resident’s medication. Just do as little as possible when it comes to the MARS and you’ll be fine. Of course, when mistakes happen (and they always do) you can always use the excuse that it was the pharmacy’s fault. Excuses make you feel better… until you realize that you are being held responsible for their errors. Not as much fun after that realization. 

Periodic Chore

Being unsuccessful can be easy to achieve if you view the MARS as a periodic chore and not as a continual process that requires constant monitoring and action.  If you don’t understand, try this experiment. Fill out the MARS once a day, once a week, once a month, and just before inspection. You will see that the longer you wait to fill out the MARS the more you have to lie when inspection times come. Nothing screams failure like being caught in a lie. A particular fast way of being caught is pre-filling out the MARS before you give out the meds.

Data

Do not use the MARS as a caregiver tool. You will also notice that the longer you wait to chart, the less effective the MARS becomes at gathering information. Information that helps you make your patients happier and healthier. Who needs to see long-term patterns, notice side effects, monitor therapy’s effectiveness? You’re just a highly paid babysitter anyway. No need to keep your residents well. It keeps you from getting bored if they are constantly unhealthy from the lack of proper medication management.

Initials

Hey, do you want to do something really fun? Do not put an up-t0-date initial key in the MARS.  You know, that list that tells which initials belongs to which name. Stand back and watch the inspector try to go through the MARS. It’s hilarious to watch the frustration build. And if you want to kick it up a notch throw in some random initials that don’t correlate to anyone’s name but pertain to actions. For example, HO for a patient away at the hospital or RM for a patient refused medication.

Updates

 A must-have skill that leads to failure is when a new physician order is obtained. Just cross out certain parts of the old MARS entry; (for example, strength or frequency), and write over it with the new instructions, instead of creating a new MARS entry. Nothing says I’m a medical amateur more than that particular piece of recordkeeping cleverness.

Missing Meds

Another must-have MARS skill is to leave off medications all together from the records. It’s way easier to just not list a medication. Who needs the hassle of keeping track of all those meds. The inspector never matches up the medication with the MARS anyway. Am I right or what?

OTC

Nothing says medical overreach quite like handing out OTC meds willy nilly. Look at you, acting just like a doctor. Deciding when to give out medication. Your momma would be proud. Never mind that you don’t have a license to prescribe medication. Who needs to follow doctor’s orders or follow package labeling when you have all that knowledge-based on your minutes and minutes of medical training? The doctor doesn’t need to know what going on. He can figure out that you changed his instructions all on his own. He is certainly smart enough to follow your lead in such matters.  

Discontinued Medication

Do you want to really annoy the inspector and get revenge for being forced to do all that medical documentation work? Then keep initialing the MARS after a medication has been discontinued. Remember not to write down any notes on when the med was DCed. That will show ‘em. To kick the annoyance factor up a notch, just say “oops, I really haven’t been giving the medication, but I can’t remember exactly when I stopped giving it out.”

PRN

Speaking about annoying, PRN medications are the worst. They're just a whole list of record-keeping duties for each medication.

• Each PRN has to have specific instructions. It’s not good enough to have PRN Pain. You have to have things like “as needed for hip pain every 4 to 6 hours, not exceed 3 doses per day”.
• You have to fill out the time you gave out the med. So you can keep track of things like when the 4 to 6 hours are up.
• You have to write down the outcome of the PRN therapy.

All that contacting the doctor for better instruction. All that extra writing. And they never give you enough space on the back of the MARS for proper note-taking. It’s such a hassle to put an extra piece of paper in the MARS. How’s a caregiver have enough time for the important things, like video games. Who cares if the PRN actually worked or if the frequency is changing or if the PRN is masking a serious developing condition and other such krap. To save time just give out the med on a regular basis and skip all that bothersome note-taking. That will lead to quick failure.

 

Halfway Thru Reality Check

Well we are halfway through the course. You are either loving this or hating every sarcastic joke. Or maybe it is becoming a bit uncomfortable. Am I getting a little too close to how you fill out your patient’s MARS? Am I  starting to prick your conscience? The MARS is not a chore that is to be pared down to the easiest possible method of filling it out. If you do take the easiest possible route, you are missing all that wonderful information. Information that gives you power and control. You are an important part of the professional caregiving team, but only if you act like a professional. If you want to be seen as a babysitter and just want to be entertained, then by all means don’t try to understand the seriousness behind the jokes. Let’s get back to the sarcasm then. Now where was I? Oh yes, how to fail an inspection.

 

Missed or Refused Doses

If you are intent on failing an inspection, then leave the MARS blank with little or no explanation when the resident misses or refuses a dose. It will add a bit of mystery for the inspector to figure out. They will love that bit of intrigue you just added to their inspection.  

Timing of Entry

There is a one-hour recordkeeping grace period before or after dispensing a medication, (wink, wink, nudge, nudge). Try using that as an excuse for not filling out the MARS on time and the inspector will have a giggle, giggle.

Same Dose Different Portions

It is okay to use the same MARS entry for different portioning of the drug if the overall dose doesn’t change. Example- two 5 mg tablets instead of one 10 mg tablet, or using powder instead of tablets.  More winking and nudging…. and inspector giggling.

Mid-Month Changes

It is such a hassle when doctors make changes mid-month. Don’t they know all the extra work that entails? They are doing that just to spite you, yah know.

With every change you gotta;

• Notify the pharmacy
• Discontinue the old medication order, if there is one, and add an explanation note
• Create a new MARS entry. Probably have to handwrite it in, while the pharmacy makes a new MARS.
• Then you have to check the one the pharmacy generates to see if they got it right. Of course they won’t get it right. So you gotta call them up and do it all over again.

All that extra recordkeeping will require way too much time away from your favorite TV show. Just ignore changes until the new month rolls around. That’s an effective time-saving way to fail an inspection.

 

Timing of Doses

Speaking of saving time, Put AM or PM instead of the actual time you gave the dose. When the dose is given weekly or monthly do not mark out the days they are not supposed to give the medication.  Who needs to have all that recordkeeping accuracy?

Allergies

If you are tired of failing the MARS inspections in the same old ways, try messing up the allergies for a change of pace. Writing down that the resident has no known allergies but is taking an allergy medication is a particularly effective technique for failing an inspection. Don’t forget to forget food and pet allergies and too.

Legibility

For more variety in failing, write all your initials, signatures, and notes so quickly and sloppily that nobody can read them. Include one initial instead of two. The initial of your last name will be just fine. It’s not like others in your family have the same last initial. Their sloppy handwriting will be different from your sloppy handwriting anyway. 

Incomplete Records

There is no better method to avoid work while generating more work later on than having incomplete instructions. You know, unnecessary  things like

• Do not exceed …
• Take with food
• Inhale by mouth
• As needed for …..
• Strength, time, route of administration

It is so satisfying to avoid having to write all those pesky details in the MARS. Too bad that you’ll have to start completely over and do it all again the right way after you’re halfway through the month. Makes perfectly good sense doesn’t it.

 

Conclusion

Well I hope you enjoy the sarcastic comedy. Even though we had some fun I am as serious as any county inspector about doing the MARS right way. Keeping track of all the medications and data in real-time (not a week down the road) is so important. You are the frontlines of the care profession. The guy or gal in the medical trenches. You see the changes before anyone else. You can know your clients better than anyone else. But you got to utilize the tools at hand better than what we have been doing in the past.

Keeping up on the MARS will also keep you out of trouble with the state inspectors. Want to keep the state off your back? Then have a perfect MARS. It sends all the right messages to the inspector, doctors, pharmacy, and any other medical professional.

 Having accurate, useable data will also give you power that you can use as the patient’s advocate. You can take the MARS to the doctor and say, “We have a problem. See this pattern right here in the MARS, do something about it- Now.”

Well that is enough preaching for now. This CE was supposed to be fun. I hope you liked it and can use the information it contained to be better at filling out the MARS. And NO, I don’t really want you to fail and have to do everything over again. Why would any caregiver want to do that, repeat that failing multiple times? It just doesn’t make any sense.

As always Good Luck in your Caregiving Efforts.

Mark Parkinson BsPharm

 

Warning: An unusual CE requires an unusual quiz. You have to prove you read the material by passing the test, so have patients with the weird questions.

 

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