Image of Nursing Documentation: Proven Strategies to Keep Your Patients and You
Digital Seminar

Nursing Documentation: Proven Strategies to Keep Your Patients and Your License Safe


Faculty:
Rosale Lobo
Duration:
Full Day
Format:
Audio and Video
Copyright :
May 11, 2016
Product Code:
POS013030
Media Type:
Digital Seminar


Description

Join expert and legal nurse consultant, Rosale Lobo, PhD(c), MSN, RN, CNS, LNCC, to learn how to develop a systematic approach to documentation that will keep you, your patients and your license safe. You will learn how to identify and avoid risky documentation as well as how to correctly utilize electronic documentation and the correct technique for meaningful use. Rosale will show you step by step, how to overcome your most complex documentation questions and challenges.

This dynamic one-day program will include tools to safeguard your documentation including:

  • Time saving tips for electronic documentation and EMR use
  • Documenting compliance, incident reports, and adverse events
  • Sample strategy worksheets for ease of data collection
  • Federal government requests for charting based on meaningful use criteria
  • Dangers with social media, email, and texting
  • Examples and case studies of correct and incorrect documentation

OUTLINE

The Components of Documentation

  • Guidelines
  • Interpretation
  • Mistakes
  • Education
  • Social Networking
  • Indirect Care

Electronic Nursing Documentation

  • American Recovery and Reinvestment Act
  • Meaningful Use
  • Health Insurance Portability and Accountability Act (HIPPA)
  • Risky electronic documentation practices
  • Dangers of email, social networking, and texting

Electronic Medical Records (EMR) Strategies

  • Time Management
  • Liability
  • Software Knowledge
  • Meaningful Use

Reimbursement and Documentation

  • Medicare/Medicaid Changes
  • Incentives and meaningful use criteria
  • EMR Timelines
  • Hospital Acquired Conditions

Documentation When Things Go Wrong

  • Compliance
  • Regulations
  • CMC
  • Incident Reports
  • Adverse Events
  • Risk Factors

Ethical Issues

  • Truth Tellers
  • Standards
  • Deviations
  • Errors
  • Omissions
  • Communicating
  • Corrections

Avoiding Risky Documentation

  • Credible evidence
  • Avoiding Ambiguity
  • Recording events objectively
  • Late Entries
  • Correcting Errors

What if the Worst Happens?

  • Duty /Breach of Duty
  • Nurse Practice Act
  • State Board of Nursing
  • Depositions

Examples and Case Studies of Documentation

OBJECTIVES

  1. Identify a strategic nursing documentation system.
  2. Describe how documentation is used to decide if you are guilty or innocent in a lawsuit.
  3. Recognize the meaningful use criteria to meet reimbursement needs.
  4. List how to best use features in computerized records to ensure reimbursement.
  5. Identify how to prevent risky behavior when using social media and other forms of electronic communication.
  6. Define how to use best practice and standard of care for documenting incident reports and adverse events.
  7. Integrate the correct practices into your documentation to keep your license unblemished.
  8. Summarize the common documentation mistakes and how to avoid and/or correct them.

 

 

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Credits


**

NOTE: Tuition includes one free CE Certificate (participant will be able to print the certificate of completion after completing and passing the on-line post-test evaluation). 

Continuing Education Information:  Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self-study is an acceptable form of continuing education. Please refer to your state rules and regulations. If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, please contact cepesi@pesi.com or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals.  As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards


Nurses, Nurse Practitioners, and Clinical Nurse Specialists

PESI, Inc. is accredited as a  provider of continuing nursing education by the American Nurses Credentialing Center’s  Commission on Accreditation.

Nurses completing these self-study materials will earn 6.3 contact hours. Expires: 05/11/2022.


California Nurses

PESI, Inc. is a provider approved by the California Board of  Registered Nursing, Provider #: 17118 for 6.0 self-study contact hours. 

** You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.


Florida Nurses

CE Broker

PESI, Inc. is an approved provider by the Florida Board of  Nursing. Provider #: FBN2858. These materials qualify for 6.0 self-study contact hours.


Iowa Nurses

PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 7.6 self-study contact hours. Please email cepesi@pesi.com with your license number, include the title, speaker name and date. PESI must have this number on file in order for your hours to be valid.


Other Professions

This self-study activity qualifies for 6.25 continuing education clock hours as required by many national, state and local licensing boards and professional organizations. Save your activity advertisement and certificate of completion, and contact your own board or organization for specific requirements.



Handouts

Faculty

Rosale Lobo Related seminars and products: 8

PhD, MSN, RN, CNS, LNCC, Adjunct Professor

Southern Connecticut State University


Rosale Lobo, PHD, MSN, RN, CNS, LNCC, has 30 years of combined experience as a direct care nurse, faculty, administrator, and legal nurse consultant. Rosale is a staff nurse at a large teaching hospital in Connecticut and serves as clinical faculty at Southern Connecticut State University. She began working with attorneys in North Carolina and expanded her independent legal nurse consulting practice to New York, Georgia, Colorado, and Connecticut. Plaintiff medical malpractice attorneys have utilized her expertise as both an expert witness and a "behind-the-scenes" consultant.

Rosale is a BSN graduate from Long Island University, earned her master's degree from Hunter College with magna cum laude distinction and her PhD from Walden University, focusing her dissertation research on Nursing Documentation. Rosale is the author of Guilty or Innocent: Protecting Your License Through Proper Nursing Documentation (PHC Publishing Group, 2012). She is a member of the American Nurses Association, American Association of Legal Nurse Consultants, past educational board member for the Connecticut Association of Legal Nurse Consultants, and the American Society of Public Administration.

Speaker Disclosures: 

Financial:  Rosale Lobo is an Adjunct Clinical Faculty for Southern Connecticut State University and Gateway Community College. She receives royalties as an author for PESI Publishing & Media. Ms. Lobo receives a speaking honorarium from PESI, Inc.

Non-financial:  Rosale Lobo has no relevant non-financial relationship to disclose.  


Additional Info

Program Information

Additional Resources

To order the book, Guilty or Innocent? Protecting Your License Through Proper Nursing Documentation, please visit our product store.

To order the book, Legal and Ethical Standards for Nurses, please visit our product store.


CD/DVD

Click here to purchase the DVD or CD recording from our product store.


Access for Self-Study (Non-Interactive)

Access never expires for this product.


Target Audience

Nurses, Nursing Home Administrators, and other Healthcare Professionals

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