Record Keeping and Defensible Documentation Training

Description

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.

This training course is intended to cover the knowledge and principles of good record keeping. Appreciation of the legal, regulatory, contractual requirements around record keeping. Good clinical entries, tools in relation to the record life cycle, skills to assess the quality of your own record keeping.

Nursing documentation is the cornerstone of best practice. It serves many diverse, complex and important functions from ensuring consistency of clinical care and good communication between practitioners, to providing evidence in a court of law that patients have received appropriate, high-quality, evidence-based care… or, indeed, that they have not. The phrase ‘if it is not documented, it was not done’ should be the guiding principle used when documenting care in order to ensure that a clear picture of a patient’s care history can be gained.

All healthcare workers across all settings with existing knowledge wanting to enhance their current understanding. Alternatively, those new to healthcare looking to acquire new skills and practice effectively.

Registered nurse with first hand clinical experience.