5.2. The steps needed to fill the MRB accurately and safely according to written physician orders


  • Wear gloves when handling medications, especially if you touch pills or clients.
  • Fill the MRB in a safe, quiet, secured area, free from interruptions from staff, clients and telephone calls. This avoids errors caused by distractions.
  • Check all MRBs prior to filling for cleanliness and good repair.
  • Fill the MRB for only one client at a time. This avoids filling the MRB with the wrong client’s medications.

        Step 1: Cross-check the MRB label with the physician order, the MAR and the pharmacist-prepared medication bottle.

a)       The label on the MRB should reflect the exact number(s) of each tablet/capsule of medication to be placed in the MRB.

b)       b. If the label on the MRB does not match the information on either the physician order, the MAR or the medication bottle, you must resolve the discrepancy before filling the MRB. This includes verifying that trade and generic names used are the same drugs.

c)       Always ask for assistance when unsure of an order, a medication, a label or the procedure used in filling MRB’s. You are responsible to know your facility’s policies and procedures for filling and for administering or monitoring medications from MRB’s.


        Step 2: Wash hands immediately before opening medication bottles. Apply gloves.

a)       Transfer medications from bottle lid to MRB or transfer medication wearing gloves. Never touch pills with bare hands.

b)       If desired, you may use clean tweezers in transferring medications from bottle lid to MRB; alcohol wipes are acceptable for cleaning tweezers.


        Step 3: Using an organized system, each medication on the MRB label is filled, one at a time, until all medications for the client have been completed. Count the number of medications in the MRB and compare to the MRB’s label.


        Step 4: After filling is completed, count or estimate the number of pills remaining in the bottle. Enough medications should be in the bottle for at least ten (10) days if possible or as insurance allows. Find out from your facility your responsibility regarding the reordering of.