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Defensive Charting For Nurses Course

Defensive Charting For Nurses Course - Join nursing colleagues for an interactive class discussing defensive documentation. One tool especially suited for defensive documentation is the acronym fact, which stands for factual, accurate, complete, and timely. Describe documentation strategies for challenging situations. Understanding and utilizing best practice of accurate defensive documentation will help avoid allegations of misconduct by way of misinformation. The importance of creating a clearly defined plan of care with interprofessional goals and strategies is critical to ensuring documentation is defensible to. The concepts of skilled, reasonable, and necessary will be articulated in terms nurses and therapists will understand. Here is some information that can assist with improving your charting and reducing liability risks: The course will examine real examples of patient care and use lessons learned to vastly improve incident reporting and. For example, to meet standards related to evaluating a patient’s progress towards goals, the nurse and others on the healthcare team need to review past documentation. What is required for nursing documentation?

The concepts of skilled, reasonable, and necessary will be articulated in terms nurses and therapists will understand. Armed with a fundamental understanding of this information, clinicians will be able to meet documentation expectations. In this course, you will also understand documenting phone calls, the legalities of charting, and. This course will take you through the daily charting and documentation that is necessary for your patients. Understanding and utilizing best practice of accurate defensive documentation will help avoid allegations of misconduct by way of misinformation. Describe documentation strategies for challenging situations. The course will examine real examples of patient care and use lessons learned to vastly improve incident reporting and. Avoid value judgments, bias, labels, and subjective opinions. This class will engage both experienced and n ewer nurses. It also helps nurses meet standards of professional practice.

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This Course Will Update Nurses On The Requirements Of Medical Record Documentation As Well As Professional, Responsible Documentation Strategies.

The who, what, when, where, why and how; It also helps nurses meet standards of professional practice. This course will examine the technical and clinical criteria for skilled nursing facility coverage and the core principles of documentation. Explain the multiple purposes of documentation and documentation fundamentals.

Describe Two Documentation Strategies To Reduce Liability Exposure.

Specializes in infusion nursing, home health infusion. The main thing is to stick to the facts only the facts, don't offer your own thoughts on things or try to write a story. Demonstrate nurses’ contribution to patient care outcomes. When documenting, record only information and behavior you observe.

This Course Will Take You Through The Daily Charting And Documentation That Is Necessary For Your Patients.

When documentation becomes your defense; Nurses play a vital role in improving the safety and quality of patient car not only in the hospital or ambulatory treatment facility but also of community based care and the care performed by family members nurses need know what proven Avoid value judgments, bias, labels, and subjective opinions. Learn to chart like your license depends on it!

Describe Documentation Strategies For Challenging Situations.

Armed with a fundamental understanding of this information, clinicians will be able to meet documentation expectations. Tips for passing medicare audits, charting incident reports and writing physicians’ orders accurately will all be discussed. Facilitated by registered nurses with first hand clinical experience, this ½ day blended learning course allows attendees to gain theoretical and practical pressure area care knowledge. Steps nurses can take to improve their charting and reduce their liability whether you are an experienced nurse or recent grad, documentation can be challenging.

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