SS-2006
DOCUMENTATION AND COMMUNICATION
Forensic Issues for Healthcare in the Digital Era
COURSE DESCRIPTION
This forensic documentation and communication course is designed to assist nurses in understanding recent changes in nursing documentation effected by revised practice standards, new regulatory guidance and emerging technology in the digital era. The widespread use of computer charting, the increase of automated retrievals and downloads of patient information to the hospital information system, tracking technology and the use of personal communication devices have revolutionized patient record-keeping. The technological advances have streamlined many types of routine documentation, but nurse-generated, written documentation must be more precise than ever before to ensure that it coincides with computer-generated and time-stamped information that is continuously being recorded and transmitted. This course prepares nurses for the challenges and opportunities associated with the "new age" of digital recording, and will illustrate important forensic (legal) implications inherent in clinical documentation.
AUTHOR BIOGRAPHICAL INFORMATION
Janet Barber Duval holds a baccalaureate degree in nursing from the University of Cincinnati College of Nursing and a Master's Degree in Nursing/Education from Indiana University. Her areas of clinical expertise include emergency, trauma, and critical care. Involvement in forensic nursing spans two decades, encompassing education, practice and consultation.
Barber Duval is a charter member of the International Association of Forensic Nursing and has been awarded the title of Distinguished Fellow. She is a Fellow within the American Academy of Forensic Sciences and holds memberships in several professional nursing and military-affiliated associations. In 2001, Barber Duval retired from the United States Air Force Nurse Corps with the rank of Colonel, and is an Adjunct Associate Professor at Indiana University School of Nursing.
Involved in forensic nursing from its earliest roots in the United States, she has developed and implemented forensic courses at the University of Texas (Austin), University of New Mexico, Indiana University, University of California (Riverside), the United States Air Force and within the Department of Veterans Affairs. Internationally, Barber Duval is associated with the faculty for forensic sciences in Bari, Italy, at the Institute of Legal Medicine.
Contributions to the nursing literature include numerous textbooks and articles in peer-reviewed journals, newsletters and other publications. She is the former Editor for the Journal of Emergency Nursing (JEN) and has edited Critical Care Nursing Quarterly (CCNQ) for three decades. Barber Duval edited the textbook, Forensic Nursing for Virginia A. Lynch that was released in 2005.
OBJECTIVES
Describe 3 JCAHO requirements which relate to nursing documentation.
Relate quality and precision of documentation to hospital reimbursement including Medicare, Medicaid and other third-party payers.
State best practices for documenting content relating to patient safety.
Understand implications of nursing documentation that relate to sentinel event reporting and investigation.
Select statements that describe recommended procedures for inserting late entries and correcting mistaken entries in medical records.
Explain how computerized charting and automatic capture of patient's physiological data impacts written nursing documentation.
Identify the assets and limitations of nursing documentation in regards to its contributions in the prosecution or defense of a forensic case.
Select preferred or 'best practice' statements when presented pairs of statements describing a clinical event.
Outline the legal steps in regard to discovery of documentary evidence associated with a hospital adverse event or lawsuit.
List 4 indicators of tampering or spoliation of medical records that forensic nurses could detect when performing a patient-centered investigation.
WHO MAY TAKE THIS COURSE
Registered nurses, licensed vocational nurses and other persons who care for and manage the elderly in a hospital, assisted living facility, convalescent hospital or home environment.
PREREQUISITES
There are no prerequisites for this course.
AVAILABLILITY
Upon Demand
CONTACT HOURS
10-Continuing Education Hours
DURATION
This course is self-paced; however, all course requirements must be completed within 6 months of enrollment.
PRESENTATION METHOD
This online course is presented in a downloadable PDF format and may include media files, (student may be required to download free corresponding media players.) Course content format may also include assignments, case studies, multiple choice and/or true or false statements.
TEACHING METHOD
This is a downloadable self-paced home study course. Interim key point prompts are included throughout the course to highlight and reinforce vital information. The Multiple-Choice course examination will be taken online after completion of all other course requirements.
METHOD OF COURSE GRADING
Pass/fail grading system. Course examination is multiple choice with a passing score of 70%. When a score of less than 70% is received, the examination may be taken one time without charge. For further information regarding additional retakes of the examination, contact amerforensi@linkline.com
METHOD OF COURSE EVALUATION
After successful completion of the course study and examination with a passing score of 70%, an evaluation shall be completed and submitted to amerforensi@linkline.com
CERTIFICATE OF COMPLETION
Upon completion of the course study, examination with a passing score of 70% and evaluation, the student will receive a Certificate of Completion via email.
REQUIRED COURSE MATERIALS
All readings have been incorporated in the coursework materials.
SUGGESTED COURSE MATERIALS
There are no suggested course materials.
OTHER RELATED COURSES
Forensic Evidence Collection in the Clinical Setting, Forensic Evidence Collection in the Emergency Department, Chain of Custody.
COURSE FEE: $89.00 (or US equivalent)
Note: Upon receipt and processing of course payment, the student will receive an email with payment confirmation, link to the course PDF file, online examination and evaluation.
All courses and materials are based on United States laws and regulations unless otherwise noted. Laws vary from state to state.
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