Medical Record Documentation

Course overview

The patient's medical record contains all of the important information about the patient's health, plan for care, and health care progress. The medical record is also the place where health care professionals communicate with each other about patient care outcomes and ongoing treatments, progress and setbacks. The basic purpose of patient care documentation is to produce a clear, concise, and accurate record that allows everyone involved on the health team to know what has happened to the patient, what is planned, and what has been ordered and needs to be done. Get Unlimited CEUs for only $19.99 at cnaZone.com.