Form LIC 622A. Medication Administration Record (MAR) - California

Form LIC 622A is used in California by healthcare professionals and facilities responsible for administering medications to residents or patients. The main purpose of this form is to accurately record and track the administration of medications in a systematic manner.

The form consists of sections where medication-related information is recorded, including the resident or patient's name, identification number, date and time of administration, medication name, dosage, route of administration, and the signature or initials of the administering healthcare professional. The form may also include additional fields for documenting any changes to the medication regimen or special instructions.

Important fields on this form include accurately recording medication details, ensuring compliance with medication schedules, maintaining legible and complete records, and obtaining the appropriate signatures or initials to verify medication administration. It is crucial for healthcare professionals and facilities to use this form diligently to ensure safe and effective medication management.

Application Example: A nurse in a residential care facility administers medications to residents. Form LIC 622A would be used to record each instance of medication administration. By completing the form accurately and thoroughly, the nurse maintains a comprehensive medication history, promotes accountability, and reduces the risk of medication errors.