Designing a Medication Audit That Catches Errors Before They Reach MARs
By Attila Szelei on 15/10/2025
Designing a Medication Audit That Catches Errors Before They Reach MARs
Excerpt: A well-designed medication audit can identify and resolve errors before they appear on Medication Administration Records (MARs), safeguarding residents and supporting compliance. This guide offers practical steps for registered managers and care staff to improve medication safety.
Why Focus on Errors Before They Reach MARs?
Medication Administration Records (MARs) are critical documents, but by the time an error reaches a MAR, it may already have compromised safety. Early detection of errors—such as prescribing, dispensing, or transcription mistakes—prevents harm and reduces incidents.
This proactive approach aligns with the Safety Assessment Framework (SAF) readiness, helping care homes demonstrate robust medication management to the Care Quality Commission (CQC).
Practical Steps to Design Your Medication Audit
1. Map the Medication Process Fully
Before you audit, understand every step from prescription to administration. This includes:
- Prescription receipt and validation
- Medication ordering and delivery checks
- Storage and stock control
- MAR chart completion and reconciliation
- Administration and observation
Example: Use a flowchart or checklist to detail each stage, identifying where errors can creep in (e.g., transcription from prescription to MAR).
2. Develop Pre-MAR Checkpoints
Audit points should be established before MAR chart completion to catch errors early. Consider:
- Verifying medication orders against GP or pharmacy communications
- Checking deliveries against prescriptions immediately on receipt
- Cross-referencing new medications or changes with previous MARs and care plans
Checklist for Pre-MAR Audit:
- Are new prescriptions authorised and signed?
- Is the medication delivery accurate and undamaged?
- Have MARs been updated promptly and correctly?
- Are changes clearly communicated to all relevant staff?
3. Use Digital Audit Tools with Action Plans
Digital medication audit tools allow real-time recording of findings with automatic alerts for discrepancies. They provide:
- Structured templates ensuring consistent auditing
- Immediate flagging of errors or omissions
- Built-in action plan creation to assign responsibilities and deadlines
Example: A tablet-based app can prompt staff to check expiry dates, dose changes, and allergies before MAR updates, with notes and photos for evidence.
4. Include Incident Learning and Duty of Candour
Each audit should feed into a learning cycle. If errors or near misses are detected:
- Record them as incidents with detailed context
- Analyse root causes collaboratively with staff
- Share lessons learned openly with the team and, where relevant, with residents or families in line with duty of candour
Practical Example: If a wrong dose was nearly transcribed, review training or process gaps, and document corrective actions.
5. Train and Engage Staff Regularly
An audit is only as good as the people using it. Ensure:
- Staff understand the audit’s purpose and process
- Regular refresher training on medication safety
- Open culture where staff feel able to report errors without blame
Tip: Use brief, focused sessions during team meetings with practical scenarios.
Sample Pre-MAR Medication Audit Checklist
| Checkpoint | Yes | No | Comments/Actions Needed |
|---|---|---|---|
| New prescription authorised | |||
| Medicine delivery matches order | |||
| Correct recording of drug changes | |||
| Expiry dates verified | |||
| Allergy status confirmed | |||
| Staff informed of medication changes |
How This Helps with CQC Audits
- Demonstrates SAF Readiness: Early error detection shows a clear understanding and control of medication risks.
- Evidence Mapping: Digital audit records with timestamps, action plans, and incident logs provide clear, organised evidence.
- Supports Duty of Candour: Incident learning documentation evidences transparent, resident-centred care.
- Improves Medication Safety and MAR Accuracy: Fewer discrepancies on MARs reduce risk and enhance resident wellbeing.
- Shows Staff Competency: Training records and involvement highlight a skilled, proactive workforce.
During CQC inspections, showing a comprehensive medication audit system that catches errors before they impact MARs will provide confidence that your service prioritises safe medication management.
Final Thoughts
Designing a medication audit to intercept errors before they reach MARs requires a systematic, digitally supported, and team-inclusive approach. By mapping processes, setting clear pre-MAR checkpoints, using digital tools, embracing incident learning, and training staff, registered managers can significantly improve medication safety.
This not only protects residents but also strengthens compliance and prepares your service for positive CQC outcomes.
Disclaimer: This article is general information, not legal or clinical advice.