Medication Audit Tool

Competencies
Are MAR Charts completed in Black ink?
Are MAR charts current (in date)?
Are MAR charts legible?
Are MAR Charts signed?
Are all medicines details on the MAR Chart,
including prn?
Are the MAR charts initialled every time
medicines are administered?
Are the MAR Charts initialled every time a
Client declines medication?
Are the MAR Charts initialled every time the
Client does not receive the drug because it
is not available?
Does the MAR Chart contain special
instructions for specific drugs where
appropriate?
Does the MAR chart have clear explanation
for any process other than taken i.e.

Evidence

Met/Unmet

N/A

Indentified gaps

declined?
Are all MDS boxes clearly labelled?
Are all tablet bottles and blister packs clearly
labelled?
Do medicine containers and MDS show
special instructions for specific drugs where
appropriate?
Are all eye drops labelled clearly on both the
bottles and boxes?
Are all creams and ointments labelled clearly
on both the tubes/jars and boxes?
Are all creams and ointments clearly dated
when opened?
Are all other topical preparations clearly
labelled on the box and on the tube/tubs?
Is there a patient information leaflet available
for each medication?
Is information available for each medication
MIMS or BNF books?
Are stocks of medicines/appliances audited
before ordering prescriptions?

Prescriptions are checked against order

before sending for dispensing?
Dispensed medicines/appliances are
checked against those requested and those
currently prescribed?
Is stock rotated and expiry dates checked?
Are new stocks of medicine/appliances
received recorded?
Are remaining stocks of current medication
carried forward onto new MAR Chart?
Is there a clear process for what to do if
medicines are missing and cannot be found?
Is there a process for obtaining medications
and supplies out of hours?
Are medicines stored correctly, locked in a
draw/cupboard?
If stored centrally are the cupboards big
enough with a secure lock?
Is access to the locked drug cupboards
limited to named staff members?
Are topical medicines, dressing's, appliances
and MDS stored separately in suitably sized

cupboards?
If drug trolleys are used are they well
constructed and large enough to store
individual clients medicines separately?
Can the drug trolley be either locked to a
wall or locked in a cupboard when not in
use?
Is the drug trolley in good repair?
Is there a refrigerator for storing medicines?
Is there a record of the fridge being cleaned
or defrosted regularly?
Check the fridge temperature log, is it
complete and are all temperatures within the
2-5 degree range?
Do staff know what to do if the fridge
temperature is outside the 2-8degree range?
Is the fridge used to store non-medicines?
Are medicines only administered from
containers supplied and labelled from the
pharmacy/dispensing doctor?
Is there a robust system for identifying
clients? (Photo, visual, response to verbal
known name, name, DOB)

Does each member of staff administering

medicines know what each medicine is for?
Are all staff administering medication aware
of any special precautions or instructions?
Do staff know what side effects to look for?
Is there a process for managing product
recalls?
What are the processes for medication
administration for swallowing difficulties?
Is consent obtained from residents for staff
to administer medicines?
Are cultural and moral beliefs of clients
considered when administering medication?
Are clients assessed and reviews as to their
ability to continue self-medicate?
If clients need support to self-administer, is
the level of support required documented in
the clients care plan?
Are controlled drugs stored centrally? If
stored centrally, is there an approved secure
controlled drug cupboard or cabinet used for
CDs only?

Is the register kept correctly- running

balances that are reconciled regularly in
black pen?
Are keys held by designated persons only?
Records kept and signed?
Is the controlled drug register bound with
numbered pages?
Are records of receipts, administration and
disposal of Controlled drugs completely?
Is a second signature required on MAR chart
when Controlled drugs are administered?
Are controlled drugs disposed of correctly?
Has the disposal of medicines procedure
been followed?
Do records show the date of disposal,
reason for disposal, name and strength of
medicine, quantity removed and who the
medicine was for?
Do the records show the name of the
member of staff who arranged the disposal?
Are disposed medications stored separate to
current medication?

Are unwanted medicines disposed of

promptly?
Are medicines kept for 7 days in the event of
a client's death?
Does member of staff understand "homely
remedies"?
Is there a process for getting advice on
homely remedies from a doctor, nurse or
pharmacist?
Does the home have a detailed protocol for
minor ailments available to staff, clients and
relatives?
Is there record of purchase, administration
and disposals of homely remedies?
Does the client have regular medication from
GP? Have they been documented?
Does the member of staff understand covert
administration of medication policy?
Is the client receiving covert medication?
Are all the required multi-discipline
documents in place to support this?

Does the support plan clearly document the

need for covert medication?
Are there regular review dates on covert
administration?
Medication trolley is prepared with stock
Cupboard clean and organised
Locked when unattended
Hands washed prior to and after
administering medication
Gloves worn when applying topical
medication
Medication keys kept on person
Water available clean for each individual
Cups available

Medication aids available i.e. pill pots, oral

syringes, pill crushers.
Communication with client clear and relevant
Clients identified i.e. photo, name,
documents
Client's right to decline accepted
Privacy and dignity maintained
Medication administered in a person centred
manner
Client in correct place, correct position to aid
procedure, medication administered within
correct time scales
MAR chart read
Medication correctly dispensed from
bottle/packet/blister pack into clear
container, adopting non touch approach
Liquid medication poured at eye level
Liquid bottle top cleaned before putting lid
on

Inhaler mouth pieces cleaned

Client offered clean water to rinse mouth
after use of inhaler
Medication checked, right person, right
does, right route etc
If staff administering medication ensure
medication swallowed before walking away
and signing as taken
Fluid offered to client to support medication
Ensure MAR chart is signed in black pen
immediately after being taken and not before
being taken
If controlled medication two staff followed
process and both signed. Ensure correct
count of medication before and after
Ensure bound log for controlled medication
is signed
Medication errors reported immediately
Any medication declined is documented and
if dispensed follow returns procedure,
ensure correct coding and clear explanation
written as to why it was declined or spoiled

All PRN medication followed correctly and

documented
Did member of staff clearly explain
medication to client?
Did member of staff answer all questions
from client?
Does the worker have a good understanding
of the medication policy?
Has the worker completed medication
training?
Has the worker checked that the medication
is due and that it has not been given?
Has the worker checked the dosage on the
medication chart making sure they have
measured or counted out the correct
dosage?
Has the medication been dispensed in the
appropriate medication equipment or
measured
Is the worker aware of the arrangements in
place for the safe storage of medication
within the individual flat / home or
designated area within the unit?

Has the worker checked that the medication

is due and that it has not already been
given?
Has the individual been identity been
verified.

New Starters
All new staff should carry out satisfactorily at least four practical assessments for administering medication before being assessed
as competent, staff must also attend the one day theoretical session.
Annual Competence
All staff must complete to a satisfactory standard a practical competence assessment.