We are pleased to share the Medication Record Templates for Adult Acute Care with you.
The templates are intended to be used as an aid in the development or revision of local Medication Records and should not be regarded as a definitive national standard that must be implemented. Ensuring that each hospital’s Medication Record is designed, tested, revised and used appropriately and safely is the responsibility of that hospital.
The templates build on the extensive work carried out between 2010 and 2013, led by Mr Tim Delaney under the guidance of the National Medication Safety Advisory Group chaired by Professor Joe Harbison. This involved national consultation, design, testing in Portiuncula, Naas, Beaumont and Cork University hospitals. We have now updated and redesigned the Record as a series of templates.
Explanatory Notes for design and printing
Medication Record Templates
Standard Medication Record Templates
- HSE S1 Cover Standard
- HSE S2 Comm & Sig
- HSE S3 Med Hx & Rec
- HSE S4 Once Only & Depots & Variable
- HSE S5 VTE Protocol Guideline February 2024 (PDF, 602 KB, 1 page)
- HSE S6 Reg Incl VTE Prophylaxis Rx
- HSE S7 Reg Incl VTE Prophylaxis Admin
- HSE S8,10,12,14,16,18 Reg Rx
- HSE S9, 11, 13, 15, 17, 19 Reg Admin
- HSE S20-23 As required
- HSE S24 TDM Antimicrobials
- HSE S25 Surg & Antimicrobials
- HSE S26 Antimicrobials
- HSE S27a Oxygen inside back page
- HSE S27b Oxygen standard page
- HSE S28 Fluids back cover page
Short Medication Record Templates
- HSE Short 1 Cover
- HSE Short 2 Comm & Sig
- HSE Short 3 Med Hx & Rec
- HSE Short 4 Once Only & Depots & Variable
- HSE Short 5 Regular
- HSE Short 6 As required
- HSE Short 7 As required continued
- HSE Short 8 Fluids