Documentation

Doctor’s Prescribed Medication Order Sheet

Available in double sided pad form. Packed regular medications and short courses are listed on the front – regular non packed, PRN, topical and telephone orders on the reverse.

Fax Cover Sheet

Provides a paper trail for both facility and pharmacy. Lists patients with new orders or changes in medication. Used as a cross-reference guide for both the pharmacy and care facility. Not to be confused with the doctor’s drug chart. All changed/new orders would follow on the doctors drug chart. This is a useful form to notify the pharmacist of patients transferred, deceased, away etc. and to order any non-prescription items.

Medication Administration Record (Signing Sheet)

A pre-printed signing sheet is available in a user-friendly weekly or monthly format. The information on the sheet is computer generated to duplicate the pack, eliminating any confusion. Available in loose sheet form for laser and inkjet printers. Non packaged and PRN medication is signed for on the reverse of this form.

PRN Pad

A double-sided sheet which can be used when the number of PRN medications exceeds the space permitted n the Signing Sheet. Enables “as required medication” and “regular, non-packed medication” to be monitored easily.

Warfarin Chart

A comprehensive chart where the doctor can prescribe and nursing staff can sign off medication administered. The reverse side includes an INR Flow Graph for monitoring.

Incident Report Form

Comprehensive notification form in numbered, duplicate book. Documents all incidents, whether in prescribing, dispensing or administration.

Incident Summary Sheet

Used to collate and review incidents and document any resulting changes in procedure to avoid recurrence.

Identification Dividers

The top pocket is slit to contain a photograph of the resident and the lower compartment holds a separate card for any in house special instructions e.g; “eye drops in refrigerator”.
The purpose of the divider is to identify the resident and alert the administrator to any special instructions.

Special Instruction Sheets

These are available separately to provide in-house information regarding each patients needs. To be used with our PVC I.D Dividers

Dose Time Prompts

These Dividers have been designed to improve administration of medications held in a care facility. They alert the administrator that there is something specific about a dose time or medication.

• Durable and easily moved from one folder part to another
• 12 x hole punched dividers, suitable for two or three pronged folders
• 3 sets of coloured labels :

DOSE TIME	COLOUR
Short Course	Pink
AC Medications	Orange
Antibiotics	Grey
Controlled Drugs	Purple