A refusal is a clinical event, not a recording problem. The system captures it cleanly; the action you take next is the important part.
Recording a refusal
Click the dose on the timeline, or pick it during a round.
Outcome → Refused (code 3).
Type a clear reason. Be specific:
"Said the tablet was too big to swallow this morning"is far more useful than"Wouldn't take".If you offered the dose again later and it was taken / refused again / missed, note that too.
Submit.
What happens next
The dose is recorded as refused. No second recording is needed unless you re-offer and capture a separate outcome.
The audit trail shows your name, the reason and the timestamp.
Workflows — your service may have an "alert on refusal" workflow that emails a senior on every refusal.
When refusals need escalating
Heads up — A pattern of refusals isn't a paperwork issue — it's a clinical concern. If a supported person has refused the same medication two times running, or refuses a high-priority medication (insulin, anticoagulant, anti-epileptic), tell the nurse in charge or the prescriber straight away. Don't wait for the next medication review.
Persistent refusal and covert options
If a supported person consistently refuses a medication they need, the response isn't to "find a way around it" — it's a clinical-and-MCA conversation. Covert administration is one possible outcome of that conversation, but it requires proper MCA documentation and monthly review.