Flashcards
S3 Record keeping
Cards in this deck (4)
- 1What does the code say about record keeping?keep clear and accurate records relevant to your practice
to achieve this you must :
- complete all records asap after an event
-identify risks that have occured and steps taken to deal with them
-sign any attribute them to yourself
store all data appropriately - 2why is record keeping importantimproves accountability
makes continuity of carer easier
helps to address complaints or legal processes
provides documented evidence
audit and research
patient care and communications - 3what is the relationship between record keeping and litigationRecords may be used for evidence in order for compensation to be awarded.
Obstetrics and midwifery are among the highest for awards in compensation for birth injuries therefore your records may be under greater examination.
Civil cases:
Balance of probability (if the weight of evidence is 51% in your favour the case is won)
Records are evidence - 4what is the relationship between record keeping and drugs/medicinename
date
expiry
amount
strength
route
check with another registrant
check identity
check for allergies
obtain consent
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- Description
- Professional and legal frame works Flashcards on S3 Record keeping, created by Phoebe Crossing on 28/04/2019.
- Created by
- Phoebe Crossing · Apr 2019
- Updated
- Apr 28, 2019
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