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MEDICATION COUNT SHEET

 

___________________

_________

____________

_________________

___________

Resident

Quantity

Date Started

Drug

Strength

Staff Signature

Date

Time

Quantity

Quantity

Quantity

on Hand

Administered

Remaining

 

 

 

Document Information

Fact Name Description
Purpose The Medication Count Sheet is used to track the administration and remaining quantities of medications for residents in a facility.
Essential Components This form includes fields for the resident's name, drug strength, quantity administered, and staff signatures, ensuring accountability.
Frequency of Use Facilities are required to complete the Medication Count Sheet regularly, often daily, to maintain accurate medication records.
Legal Requirements In many states, including California, the use of a Medication Count Sheet is mandated by state regulations to ensure proper medication management.
Staff Responsibility Staff members must accurately fill out the Medication Count Sheet, signing and dating each entry to confirm that the information is correct.
Audit Trail The completed Medication Count Sheet serves as an important audit trail, which can be reviewed during inspections or audits to ensure compliance.

Medication Count Sheet - Usage Guidelines

Completing the Medication Count Sheet is an important task that ensures accurate tracking of medication for residents. Following the steps below will help ensure that the form is filled out correctly and completely.

  1. Begin by entering the Resident's Name at the top of the form.
  2. Fill in the Quantity of medication being counted.
  3. In the next space, write the Date Started for the medication.
  4. Enter the Drug Name in the appropriate section.
  5. Next, indicate the Strength of the medication.
  6. Have the staff member responsible for the count sign in the Staff Signature section.
  7. Record the Date when the count is completed.
  8. Fill in the Time of the count.
  9. Document the Quantity Administered since the last count.
  10. Finally, calculate and write down the Remaining Quantity on hand after the administration.

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Dos and Don'ts

When filling out the Medication Count Sheet form, it's important to ensure accuracy and clarity. Here are some guidelines to help you navigate the process effectively.

  • Do: Clearly write the resident's name and all relevant details in the designated spaces.
  • Do: Use a black or blue pen to ensure legibility and permanence.
  • Do: Double-check the quantity of medication on hand before recording it.
  • Do: Sign and date the form after each administration to maintain a clear record.
  • Do: Keep the form in a secure location to protect patient confidentiality.
  • Do: Review the form regularly to ensure all entries are complete and accurate.
  • Don't: Leave any sections of the form blank; every field should be filled out.
  • Don't: Use pencil or any erasable ink, as this can lead to confusion or loss of information.
  • Don't: Alter any entries after they have been made; if a mistake occurs, follow the proper correction procedures.
  • Don't: Forget to document the time of administration; this is crucial for tracking medication schedules.
  • Don't: Share the form with unauthorized personnel; confidentiality is key.
  • Don't: Rely on memory; always refer to the form for accurate information.

Common mistakes

  1. Not including the resident's name: Always ensure that the resident's name is clearly stated at the top of the form. This helps to avoid confusion and ensures accurate tracking.

  2. Missing the date started: Failing to record the date the medication was started can lead to discrepancies in medication management. Always fill this out to maintain proper records.

  3. Incorrect drug strength: Double-check the strength of the medication being documented. An error here can lead to serious health risks for the resident.

  4. Omitting staff signatures: Every entry must be signed by the staff member administering the medication. This ensures accountability and traceability.

  5. Failing to record time of administration: Not noting the exact time medications are given can create gaps in the resident's medication history. Always include this information.

  6. Inaccurate quantity on hand: Make sure to accurately reflect the quantity of medication available. This helps in maintaining proper inventory and prevents shortages.

  7. Not updating the remaining quantity: After administering medication, it’s crucial to update the remaining quantity immediately. This prevents confusion during subsequent doses.

  8. Neglecting to double-check entries: Always review the completed form for errors before submission. A quick check can prevent costly mistakes.

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