Administer, Hold or Refuse Medication on the Ward MAR
When a doctor prescribes a medicine for an inpatient, each dose lands as a due dose on the ward MAR (Medication Administration Record — the running record of every dose given, held or refused). A ward nurse works the MAR like a round: give the dose and sign for it, or — where a dose cannot or should not be given — hold it with a reason or record that the patient refused. Every administration is signed by you and audited, because a medication record is part of the legal record.
Who / when: the ward nurse (holding the medicate permission), each time a patient’s medicines are due. We’ll follow Nurse Grace giving Mr. Okafor his morning doses.
- Ward nurse — open Ward → Medication Administration (titled “Medication administration record”). Mr. Okafor’s due doses are listed, drawn from the one prescription the doctor signed — there is no separate ward drug list to reconcile.
- Ward nurse — on a due dose, select “Give”. The “Administer medication” panel opens.
- Ward nurse — confirm the patient, the drug and the dose, complete the administration details, and select “Confirm administration”. The dose moves to Given, signed by you.
- Ward nurse — where a dose cannot be given, select “Hold” on its row and record a hold reason, or select “Refused” if the patient declined it. The MAR records what happened either way — a missed dose is documented, never simply left blank.
What happens next
Section titled “What happens next”Each given dose is signed, time-stamped and audited, building a complete administration history for the stay — what was given, what was held and why, and what the patient refused. That record travels with the patient: it informs the next nurse’s round, the doctor’s review, and, at the end, the discharge summary. A controlled drug given on the ward stays consistent with the pharmacy’s witnessed register, so the running balance is never in doubt.