Quote from mcleanl
I promise you, my patient outcome will not change based on this one box. If reimbursement is the issue.....and I sense that it might be........someone should be auditing me before I leave........so I can leave and rest my weary bones at the end of my 12 and a half hour shift.
Is there something stopping you from "auditing" yourself
after a restraint episode? That's what I have always done -- sat down once things were quiet again, or, at least, before I left at the end of the shift, and reviewed all the paperwork myself to be sure I had completed everything appropriately. It is easy to overlook paperwork things in the heat of the moment and being focused on providing the actual care to the individual, but, as you have noted, we are professionals and responsible for our own professional practice.
And it's not about reimbursement, it is about documenting that you did
provide the quality of care that you say you are providing and that the state and federal rules/regs require. As much as it bugs all of us, we all know that "if it's not documented, it wasn't done." And, yes, I realize that, on the other hand, a checkmark in a box is no definitive proof that something was
done, but, short of having somebody follow every
nurse and physician around, every
day, it's the best system we've got.