Chapter 3: Documentation Flashcard Review

Beschreibung

Fundamentals of Nursing Karteikarten am Chapter 3: Documentation Flashcard Review, erstellt von SherieChristina am 15/05/2015.
SherieChristina
Karteikarten von SherieChristina, aktualisiert more than 1 year ago
SherieChristina
Erstellt von SherieChristina vor mehr als 9 Jahre
39
0

Zusammenfassung der Ressource

Frage Antworten
Chart (health care record) meets the demands of: Health Accreditation Medical Insurance Legal Systems
Adding information to chart is called: *Charting *Recording *Documenting
Documenting should include: *Type of intervention *Time care was rendered *Signature and title of the person providing care is essential
Purposes of Patient Records *Documented communication *Permanent record for accountability *Legal record of care *Teaching *Research and data collection
Patient's chart provides: *Concise, accurate permanent medical record and nursing problems *Plans for care *Care given *The patient's responses to various treatments *Facilitates accurate communication and continuity of care among all members of the health care team
Proper charting covers all areas of patient needs and concerns of: *Physical *Emotional *Psychological *Social *Spiritual
Permanent record is sometimes used by various government and other agencies to: *Evaluate the institution's patient care *Justify cost reimbursement for care provided *Establish or Review Accreditation
Zusammenfassung anzeigen Zusammenfassung ausblenden

ähnlicher Inhalt

SOAPIER Documentation
SherieChristina
SBARR: Chapter 3 Documentation
SherieChristina
Wound Assessment and Documentation Quiz
Natalie Tredway
Health Assessment
Gwen Paparone
Health Assessment
Gwen Paparone
Chapter 2: Theory, Research, and Evidence-Based Practice
Alexandra Bozan
Chapter 4: Health of the Individual, Family and Community
Alexandra Bozan
IV Administration
Gwen Paparone
Examination of the Newborn 4: Post-examination
chris.kingsnorth
Documentation Project
nigel.longley
# 3 FlowChart
Anthony Mayrand