This step is very essential to establish a care plane for the patient. Many funding agencies (such as [ANMAC], [TJC], and [ACHS]), national nursing and midwifery practice Acts, institutional agencies, and professional organisations explained exactly the importance of documentation. Moreover, healthcare organizations provide multiple services for its healthcare providers. These services include the provision of documentation criteria, procedures and policies as well as providing support for Assessment accomplishment. Nurses must follow the institution’s procedure to collect specific information and document it appropriately. It is considered that following the same guideline tends to create an effective communication skill between all the healthcare team members. Furthermore, the purpose of documentation is to afford the multidisciplinary team with a record of the patient’s medical statue. This record is fundamental for nursing interventions because it assists in diagnosing diseases and producing effective patient care plan. generally, the documented record could be written or electronic based. In conclusion, Nurses use efficient electronic data system, which is widely used in the hospitals. This system organises the data, links all healthcare departments together, allows them to access the documented data and helps to exclude the repeated
This step is very essential to establish a care plane for the patient. Many funding agencies (such as [ANMAC], [TJC], and [ACHS]), national nursing and midwifery practice Acts, institutional agencies, and professional organisations explained exactly the importance of documentation. Moreover, healthcare organizations provide multiple services for its healthcare providers. These services include the provision of documentation criteria, procedures and policies as well as providing support for Assessment accomplishment. Nurses must follow the institution’s procedure to collect specific information and document it appropriately. It is considered that following the same guideline tends to create an effective communication skill between all the healthcare team members. Furthermore, the purpose of documentation is to afford the multidisciplinary team with a record of the patient’s medical statue. This record is fundamental for nursing interventions because it assists in diagnosing diseases and producing effective patient care plan. generally, the documented record could be written or electronic based. In conclusion, Nurses use efficient electronic data system, which is widely used in the hospitals. This system organises the data, links all healthcare departments together, allows them to access the documented data and helps to exclude the repeated