2736317
Description
Flashcards by SherieChristina, updated more than 1 year ago
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Created by SherieChristina
over 9 years ago
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| Question | Answer |
| 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 |
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