Data comprehensiveness - Study guides, Class notes & Summaries

A method of documenting nurses' progress notes by recording only abnormal or unusual findings or deviations from the prescribed plan of care is called: a. Problem-oriented progress notes b. Charting by exception c. Consultative notations d. Open charting Ans- Charting by exception Mrs. Smith's admitting data indicates that her birth date is March 21, 1948. On the discharge summary, Mrs. Smith's birth date is recorded as July 21, 1948. Which quality element is missing from Mrs. Smi...

Source-Oriented Health Record - Documents organized into sections according to the provider's and departments that provide treatment (lab together, rad. together, clinical notes together) Problem-Oriented Health Record - Divided into four parts: database, problem list, initial plan, progress notes (SOAP) SOAP what does S stand for? - Subjective (patient's point of view) SOAP what does O stand for? - Objective (what the practitioner finds) SOAP what does A stand for? - Assessment (combine...

Source-Oriented Health Record - Documents organized into sections according to the provider's and departments that provide treatment (lab together, rad. together, clinical notes together) Problem-Oriented Health Record - Divided into four parts: database, problem list, initial plan, progress notes (SOAP) SOAP what does S stand for? - Subjective (patient's point of view) SOAP what does O stand for? - Objective (what the practitioner finds) SOAP what does A stand for? - Assessment (c...

Source-Oriented Health Record - Documents organized into sections according to the provider's and departments that provide treatment (lab together, rad. together, clinical notes together) Problem-Oriented Health Record - Divided into four parts: database, problem list, initial plan, progress notes (SOAP) SOAP what does S stand for? - Subjective (patient's point of view) SOAP what does O stand for? - Objective (what the practitioner finds) SOAP what does A stand for? - Assessment (c...

A method of documenting nurses' progress notes by recording only abnormal or unusual findings or deviations from the prescribed plan of care is called: a. Problem-oriented progress notes b. Charting by exception c. Consultative notations d. Open charting - Charting by exception Mrs. Smith's admitting data indicates that her birth date is March 21, 1948. On the discharge summary, Mrs. Smith's birth date is recorded as July 21, 1948. Which quality element is missing from Mrs. Smith's h...

A health record technician has been asked to review the discharge patient abstracting module of a proposed new electronic health record (EHR). Which of the following data sets would the technician consult to ensure the system collects all federally required discharge data elements for Medicare and Medicaid inpatients in an acute-care hospital? a. CARF b. DEEDS c. UACDS d. UHDDS Answer Is: - d. UHDDS (Uniform Hospital Discharge Data Set) The Uniform Hospital Discharge Data Set (UHD...

Test Bank for Personality Psychology, Domains of Knowledge About Human Nature, Randy J. Larsen, Buss & King, 3rd CanPersonality Psychology Domains Of Knowledge About Human Nature, 3rd Canadian Edition, 3e By Randy Larsen, David Buss, David King (Test Bank All Chapters, 100% Original Verified, A+ Grade)Answers at the end of each Chapter. Chapter 1 Student name: MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 1) Features of personalit...

Content and records management - Systems that enable scanning and indexing of paper documents and other content in digital form; aka enterprise (or electronic) content and records management (ECRM) Data quality - The reliability and effectiveness of data for its intended uses in operations, decision making, and planning Enterprise information (EIM) - Ensuring the value of information assets, requiring an organization wide perspective of information management functions; it calls for explic...

A method of documenting nurses' progress notes by recording only abnormal or unusual findings or deviations from the prescribed plan of care is called: a. Problem-oriented progress notes b. Charting by exception c. Consultative notations d. Open charting - Charting by exception Mrs. Smith's admitting data indicates that her birth date is March 21, 1948. On the discharge summary, Mrs. Smith's birth date is recorded as July 21, 1948. Which quality element is missing from Mrs. Smith's h...

RHIT EXAM PREP PRACTICE QUESTIONS AND ANSWERS (Data Analysis and Management) 2024/2025 | 100% VERIFIED. Once hospital discharge abstract systems were developed and their ability to provide comparative data to hospitals was established, it became necessary to develop: A) Data sets B) Data elements C) Electronic data interchange D) Bills of mortality - ANSWER-A) Data sets (3) In healthcare, data sets serve two purposes. The first is to identify data elements to be collected about each patie...