Record why a dose was not given, and follow up overdue, missed and repeatedly refused doses.
Before you begin
- You hold a current medication competency.
Record a dose that was not given
- Open the due dose in the app (or on the web Round board).
- Choose the outcome: Refused, Withheld, Missed or Not available in the app; Refused, Withheld or Not available on the web.
- Choose the Reason: Refused, Asleep, Unwell, Nil by mouth, In hospital, Away, Clinical instruction, Out of stock or Other.
- Add detail, for example “Refused twice, offered again at 30 min”. Detail is required when the reason is Other.
- Tap Record as refused (or the matching button), or Save as refused on the web. Your team leader is told about every dose not given.
Record dose sheet with Refused selected and the reason chips showing
Doses nobody recorded
- A dose not recorded by the end of its window shows Overdue on the board and in the app, and the overdue count shows in the page title.
- By default the worker is reminded at once, the team leader after 15 minutes and on-call after 30 minutes.
- If it is still unrecorded 120 minutes after the window, it is marked Missed and a Missed dose exception opens.
Follow up exceptions
- Go to Care → Medication and eMAR. Exceptions to escalate lists Overdue dose, Missed dose, Refused dose and Repeated refusals.
- Select Record now on an overdue or missed dose to record it, Notify to alert team leaders, or Raise incident to open a medication incident.
- Repeated refusals this week appears when someone refuses twice or more in a week. Three refusals in 7 days opens a Repeated refusals exception by default; review the plan with the prescriber.
Exceptions to escalate card with a missed dose showing Record now, Notify and Raise incident
Tips
- Use Withheld when a dose was deliberately withheld on clinical instruction or because of the person’s condition; use Refused when the person said no.
- The participant’s Medication tab counts refused, missed or withheld doses for the day.
If something goes wrong
“Give a reason when the dose wasn’t given.”
Choose a reason chip before saving.
“Describe the reason.”
Reason Other needs a description.
Notify says “There is no one to notify for this choice”.
No team leader or on-call person with contact details is set up for that house. Ask an administrator.