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Chart Smart
其他書名
The A-to-Z Guide to Better Nursing Documentation
出版
Wolters Kluwer Health/Lippincott Williams & Wilkins
, 2011
主題
Medical / Nursing / General
Medical / Nursing / Fundamentals & Skills
Medical / Nursing / Reference
ISBN
1605477648
9781605477640
URL
http://books.google.com.hk/books?id=4v8jAQAAMAAJ&hl=&source=gbs_api
註釋
Thoroughly updated for its Third Edition, this portable handbook shows nurses in all practice settings exactly what to document in any situation. Nearly 300 alphabetically organized entries cover diseases, emergencies, procedures, legal and ethical problems, and difficult situations involving patients, families, and other health care professionals.
Legal Casebook
sidebars provide real-world examples of court cases.
AccuChart
sample forms show how to accurately complete various forms.
This edition includes new, difficult, and timely charting situations such as moderate sedation, medication reconciliation, infant identification, faxing medical records, and requests by families for medical advice. Other highlights include expanded information on the electronic medical record, current Joint Commission guidelines on abbreviation use, and the newest NANDA nursing diagnoses.