MAR Guide

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QuickSCRIP has the ability to generate MAR (Medication Administration Records) forms for nursing homes and healthcare facilities. QuickSCRIP can print MARs directly onto blank paper, or it can populate pre-printed forms.
This is an optional software feature and has an additional cost to install.

Printing MARs

MARscreen.jpg

Printing MARs in QuickSCRIP is similar to running reports. Once a patient, facility, and prescriptions have been setup, you can printout MAR sheets. There are two ways to get to the MAR print screen:

From the Nursing Home Menu:

  1. Start in the Pharmacy Main Menu
  2. Select Option 10 Nursing Home
    • Option 10 will print MARs
    • Option 11 will print Doctor's Orders
    • Option 13 will display the MAR on-screen

From the Reports Menu

  1. Start in the Pharmacy Main Menu
  2. Select Option 4 Reports
  3. Select Option 1 Rx Reports Menu
  4. Select Option 22 Print Med Sheets

Once you're in the MAR print screen, you can modify the details of the report.

  • Lines 1 and 2 will let you print by a name range, or just print an MAR for a single patient.
  • Lines 4 and 5 will set the date range that the prescriptions have been filled in.
  • Lines 6 and 7 will let you narrow or exclude facilities by auto-profile code.
  • Line 13 lets you manually type a facility name, which will appear at the top of the MAR sheet.
  • Line 14 sets the future month that the report will print the MAR for.

Once you have setup the report, P will print the MAR. The MAR can be set to print on your report printer, or on any other networked printer you'd like to designate for that purpose.

Facility Setup

If you are printing MARs for multiple facilities, you can use auto-profile codes to group patients with specific locations.

Autoscreen.jpg
  1. Start in the Pharmacy Main Menu
  2. Select Option 3, Utilities
  3. Select Option 3, Business Control File
  4. Select number 28, Auto profile Code Descriptions

This screen allows you to assign facilities to an auto-profile code. In the small column, select a letter or number for the code, and in the larger column, enter the name of the facility. These codes can then be assigned to patients (covered in the next segment). Additionally, QuickSCRIP can be set to print the facility name at the top of the MAR sheets.

Note: You can use any letter (capital or lowercase), number, or symbol EXCEPT for A, a, E, e, or * (asterisk).

Patient Setup

Additional information can be attached to patients, which can be used in MAR forms.

  1. Start in the Rx Processing Menu
  2. Select option 13, Patient File Maint.

From here, search for the customer you'd like to update.

Auto Profile Code

You can group patients together under a facility with auto profile codes. This is useful for printing MAR forms by facility, and you can also group these customers together for other reports you might run. If you have linked auto profile codes by facility (covered in the Facility Setup segment) then you can attach it to a patient by entering the code on line 19.

Note: You can enter an * (asterisk) on line 19 to see what auto-profile codes are available from the assigned list.

Admission Date

Some facilities require that the admission date be included on the MAR, or at least be tracked electronically. This can be stored in the Customer Notes File.

  1. Start in the Patient File Maint.
  2. Find the customer you'd like to update.
  3. Press F11 to access the Notes screen

Select any open line, and enter /ADM mmddyy.

Patient Location

QuickSCRIP can store the patient's location or room number.

  1. Start in the Patient File Maint.
  2. Find the customer you'd like to update.
  3. Press O2 to access screen 2 of the Patient File Maint.
  4. Select line 32, and enter the patient's room or bed number.

Patient Facility ID

QuickSCRIP can also store the facility ID.

  1. Start in the Patient File Maint.
  2. Find the customer you'd like to update.
  3. Press O2 to access screen 2 of the Patient File Maint.
  4. Select line 33, and enter the patient's facility ID number.

Diseases and Allergies

Diseases and Allergies can be linked to the patient's profile and setup to print on MAR sheets.

  1. Start in the Patient File Maint.
  2. Find the customer you'd like to update.
  3. Press Z for Diseases or Y for Allergies.

From year you can search and add diseases and allergies to the patient. These lists are compiled from Medispan data.

Diagnosis, Comments, and Alternative Allergies

You can attach diagnosis information, healthcare comments, or free-text allergies information to a patient's profile.

Diagnosis.jpg
  1. Start in the Patient File Maint.
  2. Find the customer you'd like to update.
  3. Press F9, you will be prompted to open an MAR text file.
  4. Choose L for MAL_unique#
  5. If Windows asks you to create a new file, choose Yes.

Windows will now open a text file, where you can type up free-form text. Diagnosis and Comments have 6 lines of text. You can enter allergies here as an alternative method to the one above.

Make sure to save the file after you have edited it.

  • Click File in the upper left of the text document.
  • Click Save. You do not need to give it a save name, QuickSCRIP will assign it a unique name.

Patient Orders

Patient orders can be attached to a patient profile.

  1. Start in the Patient File Maint.
  2. Find the customer you'd like to update.
  3. Press F9, you will be prompted to open an MAR text file.
  4. Choose O for MAO_unique#
  5. If Windows asks you to create a new file, choose Yes.

There are many different commands you can add in the patient orders text file:

  • Admission Dates, Time Commands, Start and Stop Dates
    • /ADM MM/DD/YYY
    • /T8am/T1200/TNOON, Ect
    • /MSTART= and /MSTOP=
  • PRN commands
    • /TP/TR/TN or /TPRN
    • Prints P R N vertically in hour blocks on MAR sheet.
  • Diet Plans with /DIET followed by instructions.
  • Standing Orders Files can be added with /SO=aaaa (aaaa = name of orders)

Each order can contain a maximum of 4 lines.

Make sure to save the file after you have edited it.

  • Click File in the upper left of the text document.
  • Click Save. You do not need to give it a save name, QuickSCRIP will assign it a unique name.

Facility or Store Orders

Facility or Store orders can be attached to a patient profile.

  1. Start in the Patient File Maint.
  2. Find the customer you'd like to update.
  3. Press F9, you will be prompted to open an MAR text file.
  4. Choose SO for MAO.SO.TXT
  5. If Windows asks you to create a new file, choose Yes.

There are many different commands you can add in the patient orders text file:

  • Admission Dates, Time Commands, Start and Stop Dates
    • /ADM MM/DD/YYY
    • /T8am/T1200/TNOON, Ect
    • /MSTART= and /MSTOP=
  • PRN commands
    • /TP/TR/TN or /TPRN
    • Prints P R N vertically in hour blocks on MAR sheet.
  • Diet Plans with /DIET followed by instructions.
  • Standing Orders Files can be added with /SO=aaaa (aaaa = name of orders)

Each order can contain a maximum of 4 lines.

Make sure to save the file after you have edited it.

  • Click File in the upper left of the text document.
  • Click Save. You do not need to give it a save name, QuickSCRIP will assign it a unique name.

Rx Setup

QuickSCRIP MAR sheets can include dispensing time charts for nursing homes. In order to generate these charts, and inform nursing homes about dispense patterns, you will need to add special codes to prescriptions (via SIGs and in Rx notes).

Dispensing Time Commands

The dispensing time commands instruct QuickSCRIP to populate the hour blocks on the MAR sheets. For prescriptions that are always dispensed at the same time every day, you can use the commands by themselves. For more complicated cycles, you will have to use additional commands.

  1. Start in the Pharmacy Main Menu
  2. Choose option 6, Edit an Rx
  3. Find the prescription you'd like to add time codes to.
  4. Dispensing times will be added on any black SIG line (lines 30-37)

Time Commands are entered with a /T immediately followed by the dispensing time.
Example: /Tam/T3pm/T8pm will print 8 a.m., 3 p.m., and 8 p.m. vertically in the hour blocks of the MAR.

  • Times can be entered as "8am", "noon", or "0800". MAR sheets will print whatever you type after the /T.
  • You only need the /T command for a scrip to print on an MAR, you do not have to have any text or time following it.
  • You can have up to 4 time commands stacked in a block.
  • MAR forms that print to blank paper require time codes be entered in military time, as do many integrated electronic MAR programs.

For prescriptions that require more than four time commands, you can add additional commands in the RX Notes screen.

  1. Start in the EDIT or FILL screens.
  2. Search for the prescription you'd like to add codes to.
  3. Press F11 on your keyboard to pull up the RX notes.
  4. Add /T commands on any blank line.

Start and Stop Date commands

Start and Stop Date commands are optional for MAR sheets. If they have been linked to a prescription, we can print these dates on select MAR and Doctor's Order Sheets. If an MAR report report date range is set to before the start date or after the stop date, then the scrip will not print on an MAR. Start and Stop dates are set in the Rx Notes screen.

  1. Start in the EDIT or FILL screens.
  2. Search for the prescription you'd like to add codes to.
  3. Press F11 on your keyboard to pull up the RX notes.
  4. Add the start and stop commands on any blank lines. (preferably a separate line for each command)

/MSTART=mm/dd/yy sets the start date. /MSTOP=mm/dd/yy sets the stop date.

Grouping Prescriptions

You can link scrips together so they appear grouped when you view a customer's history in RxFill or Edit.

  1. Start in the RxFill or Edit screens
  2. Search for the prescriptions you'd like to link together
  3. In an open SIG line, add /ROxxx (xxx = the sort key that each scrip will share)

When in RxFill or Edit, you can type H.RO instead of H when you view the patient's history to view grouped prescriptions.

Omitting Prescriptions from the MAR

QuickSCRIP will omit certain prescriptions from MAR sheets under certain conditions or with certain commands. If you want to omit a prescription from the MAR sheet (perhaps because it won't be administered there) or if a scrip isn't printing that should, look for the following:

  • By default, prescriptions that have no Dispensing Time Commands (/T) will be omitted from MAR sheets.
  • Rx's that have been marked as Discontinued (/DC) will not print
    • /DCM is an exception that will print the scrip on an MAR, but will still be considered discontinued by the system.
    • /DCxx (where xx = a number) the system will consider the Rx discontinued xx days after the last dispensing date.
    • /RX EXPIRES MM/DD/YY on any SIG line will cause the system to treat the Rx as discontinued after the specified date.
  • By default, prescriptions that have been renumbered will not print on an MAR.
  • If an MAR report date range is set to before the start date or after the stop date commands designate, then the scrip will not print on an MAR

Special Patterned Dispensings

QuickSCRIP can create a variety of dispensing patterns for MAR forms. You can use the commands below for scrips that have more complex dispensing cycles than simple time commands. Use these commands and accompanying examples for daily, weekly, or monthly dispensing cycles.

Some of these dispensing cycles require commands be entered in both the Rx SIG lines and Rx NOTES lines (F11 from RxFill or Edit screens).

Scrips marked for Special Patterned Dispensings will need to have /NDAY, (Daily pattern) /DDAY, /ODAY, (weekly pattern) or /MDAY (monthly pattern) in the SIG lines, along with at least one /T command. See subsections below on these pattern commands.

In the Rx Notes, you will need to set Day commands. These are entered as /DY1, /DY2, /DY3 (day in a numeric cycle) or /DMON, /DWED, /DFRI (on a week-day cycle), or /DM1, /DM2, /DM3 (days of the month). Which day command to use is relative to what pattern command you have in the SIGs. You can also add dispensing times and dispensing quantities to each day with /T and /DSQ commands in parenthesis after each day. At the end of the pattern, you can also have commands to repeat cycles or skip days.

  • /RESTART repeats a cycle.
  • /NOREPEAT ends a repeat cycle (ideal for cycles that rely on weekday names.
  • /EV=x (x=number) for patterns that repeat a certain number of days. /EV=2 would be every other day, /EV=3 would be every third day, and so on...

A simple dispensing pattern would go like this:

In the SIG Lines 
   /NDAY (Marks prescription for a cycle based on the number of days)
In the Rx Notes 
   /DY1(/T0800/DSQ1) (on day one, at 8 a.m., take 1 quantity)
   /DY2(/T0800/DSQ1.5) (on day two, at 8 a.m., take 1.5 quantity)
   /RESTART (restart cycle) 

The above commands would alternate between 1 tablet and 1.5 tablet daily on the MAR.

Another example:

In the SIG Lines
   /NDAY (Marks prescription for a cycle based on the number of days)
In the Rx Notes
   /DY1(/T0800/DSQ1/T2000/DSQ1) (on day one at 8 a.m. and 8 p.m. take 1 quantity)
   /EV=2 (every other day)

The above commands would have a patient take 1 tablet twice a day at specific times, then skip a day, and take 1 tablet twice a day again.

Daily Dispensing Pattern

Uses /NDAY in SIG lines in conjunction with /DY date and time commands in the Rx Notes.

This is designed for patterns that span the entire scrip throughout all dispensings. For example,this is what is used for scrips that have a loading dose period or for scrips that have a step-down dosing schedule. This pattern will not restart for each dispensing. If you have a /MSTART=mmddyy in the sigs, that will be considered Day 1 of the pattern otherwise we will use the dispense date of the first dispensing. The pattern will continue for a max of 400 days. If a scrip is renumbered, the pattern treats it as a new scrip and starts the pattern over.

Some examples:

In the SIG Lines 
   /NDAY (Marks prescription for a cycle based on the number of days)
In the Rx Notes 
   /DY1(/T0800/DSQ1) (on day one, at 8 a.m., take 1 quantity)
   /DY8(/T0800/DSQ2) (on day eight, at 8 a.m., take 2 quantity)
   /DY15(/T0800/DSQ3) (on day fifteen, at 8 a.m., take 3 quantity and continue for the rest of the prescription)

The above example would have the patient take 1 pill every day for the first week, then 2 pills every day for the second week, and finally 3 pills every day for the rest of the prescription.

In the SIG Lines 
   /NDAY (Marks prescription for a cycle based on the number of days)
In the Rx Notes 
   /DY1(/T0800/DSQ2) (on day one, at 8 a.m., take 2 quantity)
   /DY4(/T0800/DSQ1) (on day four, at 8 a.m., take 1 quantity)
   /DY10(/T0800/DSQ0) (Sets dispensed quantity as 0 for the rest of the prescription)

The above example would have the patient take 2 tablets daily for 3 days, then 1 tablet daily for 6 days, then stop.

Weekly Dispensing Pattern

Uses /DDAY or /ODAY in SIG lines in conjunction with /DMON date and time commands in the Rx Notes.

This is designed for patterns that are based on administration on specific days of the week. There are two commands to activate this type of pattern. /DDAY in the sigs says you want to administer this drug on a specific day of the week IN ADDITION to the normal weekly pattern. /ODAY in the sigs says you want to administer this drug ONLY on specified days of the week.

Some Examples:

In the SIG Lines 
   /ODAY (Marks prescription for a cycle based on the days of the week)
In the Rx Notes 
   /DMON(/T0800/DSQ1) (On Monday, at 8 a.m., take 1 tablet)    
   /DWED(/T0800/DSQ1) (On Wednesday, at 8 a.m., take 1 tablet)    
   /DFRI(/T0800/DSQ1) (On Friday, at 8 a.m., take 1 tablet)

The above pattern would have the patient take 1 pill every Monday, Wednesday, and Friday.

In the SIG Lines 
   /T0800/DSQ1 (Every day of the prescription, take one quantity at 8 a.m.)
   /DDAY (Marks the prescription for an additional day dispensing cycle)
In the Rx Notes 
   /DTUE(/T0800/DSQ1) (On Tuesday, at 8 a.m., take 1 tablet IN ADDITION to the tablet you take daily)

The above example has the patient take 1 tablet every day of the week, and adds an additional tablet to be taken every Tuesday.

Monthly Dispensing Pattern

Uses /MDAY in SIG lines in conjunction with /DM date and time commands in Rx Notes.

This is designed for patterns that are based on the date of each administration. The pattern goes from Day 1 to Day 31. QuickSCRIP will look at the date of each administration and compare it to the pattern to determine the number of pills. This pattern repeats every month.

Some examples:

In the SIG Lines 
   /MDAY (Marks prescription for a recurring monthly cycle)
In the Rx Notes 
   /DM1(/T0800/DSQ1) (on day one, at 8 a.m., take 1 quantity)
   /DM8(/T0800/DSQ0) (on day eight, at 8 a.m., take 0 quantity)

The above example would have the patient take 1 pill every day for the first seven days of the month (regardless of what day of the week they fell on), and would repeat for next month.

Hardcoded Schedules

QuickSCRIP includes some hardcoded dose schedules. Typing these commands in the Rx Notes, in conjunction with /NDAY in the SIGs will print these cycles without requiring that the user type out the entire schedule block.

/ZPACK
Take quantity 2 at 8 a.m. on the first day, then 1 pill at 8 a.m. every day for the next 4 days.
/MEDPAKB (Medrol dosepak basic) 
Take 6 at 8 AM the first day
Take 5 at 8 AM the second day
Take 4 at 8 AM the third day
Take 3 at 8 AM the fourth day
Take 2 at 8 AM the fifth day
Take 1 at 8 AM the sixth day
/MEDPAKC (Medrol dosepak complex)
The first day take 2 at 8 AM, 1 at Noon, 1 at Dinner, 2 at Bedtime
The second day take 1 at 8 AM, 1 at Noon, 1 at Dinner, 2 at Bedtime
The third day take 1 at 8 AM, 1 at Noon, 1 at Dinner, 1 at Bedtime
The fourth day take 1 at 8 AM, 1 at Noon, 1 at Bedtime
The fifth day take 1 at 8 AM, 1 at Bedtime
The sixth day take 1 at 8 AM
/PREDPAK (Prednisone dosepak complex)
Days 1-4 take 2 at 8 AM, 1 at Noon, 1 at Dinner, 2 at Bedtime
Days 5-8 take 1 at 8 AM, 1 at Noon, 1 at Dinner, 1 at Bedtime
Days 9-12 take 1 at 8 AM

MAR Additional Commands

Many of our MAR forms can be custom written to include additional customer information.

Allergies (alternate)

In addition to the MAL file method listed above, MARs can be set to pull allergies from the Patient FM as well.

  1. Start in the Pharmacy Main Menu
  2. Choose Option 13 Patient File Maint.
  3. Search for the Patient.
  4. Select Y to go to the allergies screen.
  5. From here, you can search for allergies by name or diagnosis code.

Please note that what can be linked to a patient is limited to the Medi-Span database.

Room Number

You can attach a room number to the patient via the Customer Word Screen.

  1. Start in the Pharmacy Main Menu
  2. Choose Option 13 Patient File Maint.
  3. Search for the Patient.
  4. Hit F11 to pull up the Customer Word File
  5. Enter /ROOM#= followed by the room number. Example: /Room#=12345

Admitted Date

Similarly to the Room Number, this can be linked to the patient via the Customer Notes Screen.

  1. Start in the Pharmacy Main Menu
  2. Choose Option 13 Patient File Maint.
  3. Search for the Patient.
  4. Hit F11 to pull up the Customer Word File
  5. Enter /ADM= followed by the date without slashes. Example: /ADM=010118

Start and Stop Times

By default, QuickSCRIP assumes the Start Time to be the date on the prescription. Some doctors require medication be administered within a certain date range. These dates can be set in the RX Word screen (similar to the customer word screen) or the Rx SIG lines.

  1. Pull up a prescription in RXFILL or EDIT (1 or 6 in the Pharmacy Main Menu.
  2. Enter /MSTART= and /MSTOP= in the SIG lines followed by the dates.
  3. OR hit F11 to open the RX Word file', and enter the above commands there as well.

Customer Identification Number (CID)

The CID is pulled from the Patient File Screen, line 4.

  1. Start at the Pharmacy Main Menu
  2. Chose 13. Patient File Maint.
  3. Search for the Patient.
  4. Enter the CID on Line 4.

Height & Weight

Customer Height and Weight Values can be entered on the Patient File Screen, screen 4.

  1. Start at the Pharmacy Main Menu
  2. Choose 13. Patient File Maint.
  3. Search for the Patient
  4. Type O4 (letter O, number 4) and enter to go to Screen 4
  5. Height and Weight are entered on lines 23-26