# PRNs, refusals, missed doses, and reading the MAR

> For DSPs: record a PRN with its reason and follow-up, document a refused or missed dose, know when Error means file an incident, and read the MAR.

Canonical: https://enmantle.com/help/prn-refusals-and-the-mar · Section: Medications (eMAR) · Updated: 2026-09-20

Not every dose is a simple "given on schedule." Someone takes a PRN for pain, someone refuses their evening meds, someone isn't home. This guide covers those cases and how to read them back on the MAR. It builds on [recording doses on Med Pass](/help/passing-meds-med-pass).

## Record a PRN (as-needed) dose

PRN meds aren't on a fixed schedule — you give them only when indicated. They live in their own section on Med Pass.

1. In the `PRN / As Needed` section, tap `Record PRN`. The `Record PRN dose` dialog opens.
2. Choose a `Status *`.
3. Confirm `Administered at *`.
4. Fill in `Reason *`. The med's indication is shown here to remind you what it's for.
5. Save.

Unlike scheduled doses, PRNs aren't limited to one record — each time you give one, it's a new entry.

### Add an effectiveness follow-up

After a PRN, you'll often need to note whether it helped. Open the card's `Amend` link to reach `Amend administration`, then fill in `PRN follow-up (optional)` — for example, "pain eased within 30 minutes."

## Document a refusal, hold, missed, or not-home

When a scheduled dose isn't given as planned, you still record it — the reason matters. Use the same `Record dose` dialog and pick the status that fits:

- `Refused` — the person declined the med.
- `Held` — the dose was held (per a hold order or instruction).
- `Missed` — the dose wasn't given and the window passed.
- `Not Home` — the person wasn't home to take it.

A documented not-given dose is a complete record. A blank slot is not — always record what happened.

## When a dose is an Error

If you pick `Error` as the status, Enmantle shows a warning and a `File incident report →` link. Use it. Medication errors may be **state-reportable**, so don't just note it and move on — record the dose, then follow the link to [report an incident](/help/report-an-incident). Recording the error and filing the incident are two separate steps.

## Read the MAR

The **MAR** is the month-at-a-glance record. Open it from the client's `Medications` tab as `MAR — Medication Administration Record`, or from Med Pass via the `MAR — month view` chip. There's a month picker at the top.

Each med is one row; each day is a column. For scheduled times, you'll see a status glyph:

- `✓` — given
- `R` — refused
- `H` — held
- `M` — missed
- `NH` — not home
- `E!` — error
- `·` — scheduled, not yet documented
- gray — not scheduled that day
- "(DC)" — the med was [discontinued](/help/manage-client-medications)

> For controlled meds, the MAR isn't the whole record. A med marked `Controlled substance` also has its on-hand supply reconciled separately through witnessed [controlled-substance counts](/help/medication-counts) — the shift-change count that used to have no home in the app.

## Print the MAR

Click `Print MAR` for a landscape paper MAR form you can post or file. It includes a separate "PRN and medications not administered" log, so as-needed doses and refusals show up on paper too.

> Times on the MAR are Eastern wall-clock, and every entry is audited — including who recorded it and any amendments.