Section 2
Section 2
Medication Orders
Medication Administration 2-1
5-Hour Training Course for Adult Care Homes
Section 2
Section 2 – Medication Orders
Objectives:
1. List/recognize the components of a complete medication order.
2. Transcribe orders onto the Medication Administration Record (MAR) correctly – use proper
abbreviations, calculate stop dates correctly, transcribe PRN orders appropriately, copy
orders completely and legibly and/or check computer sheets against orders and apply to the
MAR, and discontinue orders.
3. Describe the responsibility of the Medication Aide in relation to admission orders,
readmission orders, and FL-2 forms.
4. Identify required information on the medication label.
Advance Preparation – In General
• Review curriculum and presentation materials and activity
• Add examples or comments
• If no student manual used, prepare copies of handouts for section for each student
Supplies
• Handouts
o #2A – Medication Orders
o #2B – FL-2 (Blank)
o #2C – Medication Administration Record (Blank)
o #2D – FL-2 for Garrett Clayton for Transcription Activity
(Answer to activity is the MAR for Garrett Clayton Handout # 2E)
o #2F – Medication Label
• MARs, Medication Labels or Physician Order Forms used at adult care home to use in
activities or show students
Advance Preparation – Activities
• Refer to instructions on page 2-4 for Medication Order Activity
• Refer to instructions on page 2-6 for Medication Orders and Transcription Activity
• Refer to instructions on page 2-7 for Medication Label Activity
Medication Administration 2-2
5-Hour Training Course for Adult Care Homes
Section 2
Section 2 – Medication Orders
Objectives
1. List/recognize the components of a complete medication order.
2. Transcribe orders onto the Medication Administration Record (MAR) correctly – use proper
abbreviations, calculate stop dates correctly, transcribe PRN orders appropriately, copy
orders completely and legibly and/or check computer sheets against orders and apply to the
MAR, and discontinue orders.
3. Describe the responsibility of the Medication Aide in relation to admission orders,
readmission orders, and FL-2 forms.
4. Identify required information on the medication label.
Content
TEACHING TIP: Medication Orders Content
Tell students:
• Because nurses are not required to be employed in adult care homes, Medication Aides may
be responsible for receiving and transcribing orders.
• It is important that you understand required procedures as well as the limitations of your
role in medication documentation.
• You will need to pay close attention to the material because you are required to
demonstrate competency of handling medication orders.
Definition of an Order
• The written or oral directions that a physician or other prescribing practitioner provides
about a resident’s medication or medications
Components of a Complete Order
• Components of a complete order
o Medication name
o Strength of medication (if required)
o Dosage of medication to be administered
o Route of administration
o Specific directions for use, including frequency of administration
o Reason for administration if the medication is ordered PRN or as needed
• Orders for psychotropic medications prescribed for PRN administration must include
o Symptoms that require the administration of the medication
o Exact dosage
o Exact time frame between dosages
o Maximum dosage to be administered in 24-hour period
Medication Administration 2-3
5-Hour Training Course for Adult Care Homes
Section 2
Section 2 – Medication Orders
o Example – Ativan 0.5 mg. by mouth every 4 hours PRN for pacing or agitation; physician
must be contacted if more than four doses are needed in 24-hour period.
HANDOUT #2A: Medication Orders
Distribute a copy of the handout, Medications Orders to each student, or locate handout in
Student Manual.
TEACHING TIP: Medication Orders
Refer to the Medication Orders handout and tell students
• An order is required to administer, change or discontinue any medication or treatment
• It is important to know the components of a medication order
• Contact the prescribing health care provider if the order is not legible – DON’T GUESS!
• If an order is not complete or clear on how to administer, the Medication Aide must contact
supervisor or physician – DON’T GUESS!
Discuss the different types of medication orders, examples and the difference between a routine
medication order and a PRN medication order
ACTIVITY: Medication Orders Activity
Refer the students to the lower section of the Medication Orders handout and require them to
complete the activity. Discuss answers with students upon completion.
Telephone or Verbal Orders
• Although regulations for adult care homes allow Medication Aides to accept telephone or
verbal orders, the policy for the adult care home may only allow written orders from the
prescribing practitioner. The pharmacy also may not accept a verbal order from a
Medication Aide
• It is important the Medication Aide always repeat the order back to the prescribing
practitioner
• Order is to be dated and signed by person receiving the order and signed by the prescribing
practitioner within 15 days of when order is received
• A copy of an order, including a telephone order, is always kept in resident’s record
OPTIONAL HANDOUT #2B: FL-2
Distribute a copy of the handout, FL-2 to each student, or locate handout in Student Manual.
Medication Administration 2-4
5-Hour Training Course for Adult Care Homes
Section 2
Section 2 – Medication Orders
OPTIONAL HANDOUT #2C: Medication Administration Record (MAR)
Distribute a copy of the handout, Medication Administration Record (MAR) to each student, or
locate handout in Student Manual.
TEACHING TIP: Documentation
Locate examples of an FL-2, physician’s order sheet and other forms of documentation used by
the facility regarding orders and medication administration. Review these examples with the
students.
Tell students
• Documentation is an important part of medication management.
• It is frequently referred to as the “6th Right” of medication administration.
• Forms used to document can be quite confusing to unlicensed people who are unfamiliar
with the process.
• Medication Aides must know how to use the MAR and other forms to insure safe medication
management.
Forms Commonly Used to Document Medication Orders – FL-2 Form
• FL-2 form is required for new admissions in adult care homes
• Important that all information on FL-2 is reviewed for accuracy
• If any clarification is needed, contact prescribing practitioner
• If FL-2 has not been signed within 24 hours of admission
o Verify orders with prescribing practitioner by fax or telephone
o Document verification in resident’s record, for example a note in the progress notes or
orders may be rewritten as telephone orders and signed by prescribing practitioner;
orders could also be faxed to prescribing practitioner for review, signature and date
Forms Commonly Used to Document Medication Orders – Physician’s Order Forms
• Used to record prescribed medication and treatment orders
• Any form used for physician’s orders and medication orders must be retained in the
resident’s record.
Form Commonly Used to Document Medication Administration – Medication Administration
Record (MAR)
• Each resident has a medication administration record (MAR)
• Form onto which medication and treatment orders are transferred
• Record of all medications and treatments to be administered
• Record of staff who administered medications
• Record of medication not administered and the reason
• Record of staff who administered medications
Medication Administration 2-5
5-Hour Training Course for Adult Care Homes
Section 2
Section 2 – Medication Orders
Transcription of Orders Onto MAR
• Transcribe means to write down or to copy
o In medication administration it means to copy medication or treatment orders onto the
MAR
• Orders are copied onto the MAR when the order is obtained or written
o Initial or sign and date orders written on the MAR
o Transcribe writing out any abbreviations completely; include all components of a
medication order
o Count number of dosages to be administered instead of number of days when
calculating stop dates for medication orders that have been prescribed for a specific time
period, such as antibiotics
o Do not schedule PRN orders for administration at specific times; they are administered
when resident “needs” the medication for a certain circumstance
• A discontinue order must be obtained for an order to be discontinued, unless prescribing
practitioner has specified the number of days or dosages to be administered or indicates
that dosage is to be changed
ACTIVITY: Medication Orders and Transcription Activity
Distribute the MAR (Handout # 2C) and FL2 for Clayton Garrett (Optional Handout #2D). Have
the student enter the resident’s personal identification onto the MAR. Then choose several
drugs listed on the FL-2 (Handout #2D) and require students to transcribe orders onto the blank
MAR. Discuss answers (Handout #2E) with students upon completion.
TEACHING TIP: Medication Label
Locate a medication label or a copy of a medication label provided by the pharmacy provider for
the facility and discuss the location of information below on the label.
Medication Labels
• Information required:
o Medication name
o Medication strength
o Quantity dispensed
o Dispensing date
o Directions for use
o Pharmacy that dispensed the medication
o Prescription number
o Expiration date
o Equivalency statement (when the brand or medication name dispensed is different than
the brand or medication name prescribed)
Medication Administration 2-6
5-Hour Training Course for Adult Care Homes
Section 2
Section 2 – Medication Orders
• Labeling requirements for over-the-counter (OTC) medications include
o In the original manufacturer’s bottle with the resident’s name, OR
o Labeled by the pharmacy
HANDOUT #2F: Medication Label Handout
Distribute a copy of the handout, Medication Label, or locate handout in Student Manual
TEACHING TIP: Medication Label
Refer to the Medication Label handout and tell students
• Directions on medication label from pharmacy are checked against the MAR.
• If there is a discrepancy between the information on the MAR and the medication label,
check the order in the resident’s record.
• Always ask the supervisor, if any information about the medication or about administering
the medication differs between the medication label and the MAR
ACTIVITY: Medication Label Activity
Refer the students to the lower section of the Medication Label Activity handout and require
them to complete the activity. Discuss answers with students upon completion.
TEACHING TIP: Discrepancies Between Medication Label and Order Entry on the MAR
Review the procedure for discrepancies between the medication label and order entry on the MAR
and teach the procedure.
Proceed to Section #3
Medication Administration 2-7
5-Hour Training Course for Adult Care Homes