Patient interview & history

Chief complaint

Subjective statement about a patient's reason for visit made in the patient's own words.

Substance abuse

The use of a substance in a way that is not medically approved.

Addiction

A physical or psychological dependence on a substance. Involves and obsessive or compulsive preoccupation with the substance

6C's of charting

*client's word
*clarity
*completeness
*conciseness
*chronological order
*confidentiality.

Reverse chronological order

Type of charting where charts are arranged with the most recent information on top.

Methods of charting

SOAP

SOAP

*subjective
*objective
*assessment
*plan

Subjective data

Obtained from conversation with the patient or attending family member. It includes thoughts, feelings,perceptions & chief complaint.

Objective data

Readily apparent & measurable data. Eg vital signs.

Assessment

Physician's diagnosis or impression of the patient's problem.

Plan of action

Includes options for treatment, type of treatment chosen, medications, tests, consultations ect

SOMR
POMR
Computerized medical records

Three common methods for maintaining notes on a patient chart.

Source oriented medical records.

SOMR. Information is arranged according to who supplied the data.

Four components of POMR

Database
Problem list
Diagnostic & treatment plan
Progress notes

Database

Includes the patient's medical history, diagnostic & lab results & physical exam reports. This is the foundation of the problem-oriented medical record.

Problem list

Each patient condition or problem is listed individually, assigned a number & dated.

Diagnostic & treatment plan.

Lab & other diagnostic test are completed & the physician's treatment palm for the condition is documented.

Progress notes

The physician enters notes on every condition or problem recorded on the problem list. Notes are entered chronologically & include the CC, problems, conditions, treatments & responses to treatment.

Computerized medical records

Combination of SOMR & POMR but provides accessibility to anyone from a computer terminal. This enhances the patient's continuity of care between departments because everyone is looking at the same record.

Abnormal

Abnl

Antibiotics

Abx

Against medical advice

AMA

As much as possible

AMAP

Awake & oriented

A&O

Both

B

Biopsy

Bx

Childhood disease

CHD

Companies of

C/O

Cause of death

COD

Chest x-ray

CXR

Digital rectal exam

DRE

Headache

HA

History of

H/O

History & physical

H & P

Packs per day

PPD

No known allergies

NKA

Rule out

R/O

Sudden unexplained/unexpected death

SUD

Seizure

Sz

Polypharmacy

The administration of many drugs at the same time (to the same pt)

Patient oriented medical records

POMR. Used more exclusively in large clinics or practices that may have more than one physician who see the same patients. Problems are listed by date & numbered. It has four components, Database, Problem list, Diagnostic & treatment plan & Progress notes