DAR Notes | Comprehensive Guide with Examples

For nursing students and new nurses, mastering nursing note-taking is fundamental to future success in the profession. In this article, we’ll cover one of the most widely-accepted forms of nursing documentation, DAR Notes.

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DAR Notes | Comprehensive Guide with Examples

What are DAR Notes?

The DAR framework is a form of focus charting, and it stands for Data, Action, and Response. This system is a great way to organize notes, understand patients' priority issues, and assist with communication between the myriad of healthcare providers involved in patient care and follow-up.

Table of Contents

What's the Difference Between F-DAR and DAR Notes?

The key difference between DAR and F-DAR is the requirement of the "Focus" component in F-DAR (FDAR), which provides a clearer context and prioritization of the patient's needs. In some instances, nurses may incorrectly label their notes as "DAR notes", but in reality they are F-DAR Notes and DAR is just the progress note component of their patient chart.

In the instances when there's a distinction between the two, the choice between DAR and FDAR nursing notes depends on the healthcare setting, nursing practice, and potentially individual preference. Both methods aim to create organized, concise, and informative nursing documentation. Ask your nursing school or employer about their protocols if you are not sure which framework to use.

Given the high degree of overlap between the two, we will discuss both in this article and use them fairly interchangeably.

Key Components of DAR Notes and F-DAR Notes

Before proceeding with your charting, let's take a moment to understand this documentation method. For illustration and instructional purposes, the examples below do not use medical abbreviations. You can incorporate approved medical abbreviations into your writing when you document actual FDAR or DAR nursing notes in your patients' charts.

F = Focus

Again this component is likely not included in DAR notes, but is a key requirement in F-DAR Notes.

The Focus of your note is the issue or need being addressed by your nursing intervention. This note can be a:

  • Nursing diagnosis
  • Change in the patient's condition
  • Patient events
  • Patient education needs
  • The symptom being monitored, or 
  • Other material reasons you are interacting with your patient. 

The focus section should be concise and to the point. It may be helpful for you to ask yourself, "What is the purpose of this nursing note?” or "Why am I writing this note?” when determining how to state your focus.

Here are a few examples of the focus part of a nursing note:

  1. Abdominal pain
  2. Wound care and post-operative teaching
  3. Post-operative nausea and vomiting

D = Data

The data included in your DAR notes is the information you gather from assessing your patient. These notes can consist of both objective data and subjective details. An easy way to remember this is to ask yourself, "What is currently happening with my patient?” and "Why do I need to intervene?”

Here are some examples of the data part of a nursing note:

  1. Patient noted to be grimacing and complains of left-sided abdominal pain upon getting out of bed. Blood pressure elevated at 140/94. Pulse elevated at 110 bpm.
  2. Patient inquired as to how to take care of his incision when he goes home. He stated this was his first surgery, and he is concerned about developing a post-operative infection.
  3. Patient requested something to alleviate her post-operative nausea and vomiting. She is not able to tolerate anything by mouth.    

A = Action

In this space, you document your nursing intervention(s) in detail. The nursing actions included in your DAR notes indicates how you assisted your patient. An easy way to remember this is to ask yourself, "What did I specifically do to address the information that I documented in the data part of this nursing note?” and "How did I help my patient?”

Here are some examples of the action part of a nursing note:

  1. Patient was given Acetaminophen 650 mg IV for persistent abdominal pain. Patient education was provided regarding deep breathing exercises and using a pillow to splint the abdomen when coughing. He was repositioned in a recliner for comfort.
  2. Patient educational materials on the subject of post-operative wound care and the signs and symptoms of infection were reviewed with the patient and his family. Appropriate wound care was demonstrated for them.
  3. Patient was given Compazine 5 mg p.o. for persistent nausea and vomiting. Patient education was provided regarding the slow introduction of small amounts of clear liquids orally, as tolerated.

R = Response

The patient response in your DAR notes includes information regarding the patient's outcome as a result of the action that you have taken. An easy way to remember this is to ask yourself, "How did my action (intervention) help my patient?” or, more specifically, "Did my action result in the desired outcome?” This step involves using your nursing assessment skills and is a crucial part of the nursing process.

Here are some examples of the response part of your note:

  1. Patient is no longer grimacing and states that his pain has been alleviated. Vital signs are stable and within normal limits.
  2. The patient and his family were able to perform good return demonstrations of wound care and can reiterate the signs and symptoms of infection.
  3. Patient states, "I feel much better.” She is informed that she is no longer nauseated. She has tolerated ice chips and a plain cracker with no recurrence of nausea or vomiting.

As nurses do with all nursing notes, starting each note with an accurate date and time and ending every note with your professional signature is crucial. If your place of employment does not include the "focus" part of their notes, you can proceed with DAR notes and document them in the Data, Action, and Response sections of your nursing notes. It is always a good idea to ask one of your mentors or managers if you require clarification and/or examples to assist you in mastering this skill.

How to Write DAR Notes and F-DAR Notes

Now that you know the key components, how do you actually chart the information in a DAR or F-DAR Note? 

With a DAR Note there are typically two sections:

  1. Date and Time
  2. Progress Notes: This is where you add your Data, Action, and Reponse

With an F-DAR Note, there is simply one additional section for Focus:

  1. Date and Time
  2. Focus
  3. Progress Notes: This is where you add your Data, Action, and Reponse

Examples of F-DAR Nursing Notes

Some institutions have these notes in a table format, and others use the structure below; you can check with your particular institution to ensure you are being compliant with their requirements.

Example #1

  • Date/Time: 03/03/2023, 0900
  • Focus: Abdominal pain
  • Progress Notes:
    • Data: Patient was noted to be grimacing and complained of left-sided abdominal pain upon getting out of bed. Blood pressure was elevated at 140/94. Pulse was elevated at 110 bpm.
    • Action: The patient was given Acetaminophen 650 mg IV for persistent abdominal pain at 0930. Patient education was provided regarding deep breathing exercises and using a pillow to splint the abdomen when coughing. Patient was repositioned in a recliner for comfort.
    • Response: Patient is no longer grimacing and states that her pain has been alleviated. Her vital signs are stable and within normal limits.

Nurse, RN

Example #2

  • Date/Time: 03/04/2023, 1430
  • Focus: Wound care and post-operative teaching
  • Progress Notes:
    • Data: Patient inquired as to how to take care of his incision when he goes home. He stated that this was his first surgery, and he is concerned about developing a post-operative infection.
    • Action: Patient educational materials on post-operative wound care and the signs and symptoms of infection were reviewed with the patient and his family. Appropriate wound care was demonstrated for them.
    • Response: The patient and his family were able to perform good return demonstrations of wound care and can reiterate the signs and symptoms of infection.

Nurse, RN

What Not to Put in F-DAR or DAR Notes

While FDAR and DAR notes are beneficial in providing a quick and helpful means by which to document our nursing notes, nurses should avoid including the following:

  • Medical diagnoses. Always use approved nursing diagnoses.
  • Information that is outside the focus and data areas. For instance, if your documentation under the focus and/or data headings relates to post-operative pain, you would not want to document an action related to the patient's nutritional status.
  • Lengthy narratives, complete histories, or unapproved abbreviations.

Be sure to refer to the approved policies and procedures at your place of employment for the best outcomes when documenting FDAR or DAR notes.

To facilitate learning more about focus charting, reviewing an FDAR charting pdf and additional examples can be very helpful.

Remember that FDAR and DAR notes require the same compliance with documentation requirements as all other types of nursing notes.

Benefits of Using DAR Notes

A 2017 study worked to quantify the impact of focus charting models on nursing staff's documentation skills across different maternity hospitals. The study aimed to

  • Identify the most common nursing documentation errors.
  • Assess the effectiveness of applying the DAR model.
  • Determine the factors that hinder nurses from utilizing better documentation skills.

One of the advantages of DAR charting discussed in this article is that using the acronym "DAR" helps the nurse to organize their critical thinking and break down documentation into the categories of data, action, and response.

The above-noted study concluded that nurses improved their documentation skills after implementing the DAR format nursing notes. The recommendation was that nurses receive on-the-job training and thorough follow-up.

Nursing is a busy and demanding profession that requires accurate documentation of the nursing process of assessment, nursing diagnosis, planning, implementation, and evaluation. As the common adage in the profession goes, "If you didn't document it, you didn't do it.” Updated documentation methods like FDAR and DAR notes provide user-friendly, concise means by which nurses can remain organized and focused in creating their nursing notes, leading to higher job satisfaction and increased time at the bedside.

STAFF NOTE: Original Community Post

This article was created in response to a community post. The comments and responses have been left intact as they may be helpful. Here's the original post:

Quote

Can someone please help me with writing a DAR Note? I understand that this is a simple idea, but I am really struggling with writing one.

References‌‌

  1. Salt, C. (n.d.). FDAR - Nurses Notes. Scribd. https://www.scribd.com/doc/48486340/FDAR-Nurses-Notes
  2. Farag, F. A. K., & Saad, H. A. (2017). Focus charting model: Effect on nursing staff's documentation skills in different maternity hospitals. The Malaysian Journal of Nursing (MJN), 9(2), 78–86. https://ejournal.lucp.net/index.php/mjn/article/view/438
  3. Russell, J. (2019, February 6). If it's not documented, it's not done. But what if it is documented and it's not done? Minnesota Nurses Association. https://mnnurses.org/if-its-not-documented-its-not-done-but-what-if-it-is-documented-but-its-not-done/
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Michelle M. Crook

About Michelle M. Crook, BSN, RN

Michelle M. Crook, BSN, RN, CCM, BCPA received a Bachelor of Science in Nursing degree from Northern Illinois University.

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Specializes in Travel Nursing, ICU, tele, etc.

It stands for data, action, response:

Here would be a simple example:

? Patient's temperature at 1305 was 101.5 (oral). The rest of his vitals were stable and he was in no acute distress.

A: Called Dr Smith and he ordered blood cultures X2, a CBC and a portable chest X-ray. After blood cultures were drawn, patient was given Tylenol at 1400.

R: By 1500 patient's temperature was 99.8 (oral). Lab and X-ray results are pending. Will continue to monitor closely.

So, the Data part is just what is going on...(and sometimes what is not going on, to show that you were checking the whole patient...like above).

Action: What you did about it.

Respose: What was the response of your action?

I almost always add "will monitor or continue to monitor" to show that I intend to stay on top of the situation.

I hope that answers your question. Do you have any examples you want to ask about?

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Specializes in med/surg, telemetry, IV therapy, mgmt.

DAR is a form of focus charting and the dar stands for data-action-response. It ensures documentation that is based upon the nursing process. Routine nursing tasks and assessment data is documented on flow sheets and checklists.

Your focus is a nursing diagnosis, or in place of a nursing diagnosis you can use a problem, sign or symptom (nausea, pain, etc), behavior, special need, an acute change in the patient's condition or a significant event. Your progress note is written in the DAR form.

D (DATA) - includes subjective and objective information the describes the focus.

A (ACTION) - includes immediate and future nursing actions based on your assessment of the patient's condition and any changes to the care plan you deem necessary based on your evaluation.

R (RESPONSE) - describe the patient's response to nursing or medical care.

Here are four examples of DAR charting:

Focus - nausea related to anesthetic

D - Pt. states she's nauseated. vomited 100ml clear fluid at 2255
A - Given compazine 1mg IV at 2300.
R - Pt. reports no further nausea at 2335. no further vomiting.

Focus: risk for infection related to incision sites

D - Incision site in front of left ear extending down and around the ear and into neck--approximately 6 inches in length--without dressing. jackson-pratt drain in left neck below ear secured in place with suture.
A - Assess site and emptied drain. taught patient s&s of infection.
R - No swelling or bleeding; bluish discoloration below left ear noted. jp drained 20ml bloody drainage. patient states understanding of teaching.

Focus - Delayed surgical recovery

D - Patient reported dizziness after trying to get oob to use the bathroom.
A - Assisted patient back in bed and with use of bedpan. taught patient how to dangle legs and get oob slowly. also taught coughing and deep breathing exercises, turning in bed, and use of entiembolism stockings.
R - Patient voided 200ml in bedpan. did cough and deep breathing appropriately. lungs clear bilaterally. using antiembolism stockings.

Focus - acute pain related to surgical incision

D - Patient reports pain as 7/10 on 0 to 10 scale.
A - Given morphine 1mg IV at 2335.
R - Patient reports pain as 1/10 at 2355.

All of the above is from page 678 of Portable RN: The All-In-One Nursing Reference, Third edition, published by Lippincott, Williams & Wilkins

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Thank you! I have a follow-up question.

How about if the patient has several problems like you had in your examples, is it necessary to separate each problem and then proceed with the next?

In the ward, where I am assigned at, I observed that my colleagues just write everything under Data like the assessment, the problems etc. and in the Action all of the things that they did in response to Data were also written under it.

Is this correct?

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Yes, you would note what you assessed and did and plan to do for each problem. Whether you do it one at a time or in aggregate, in my opinion, is entirely up to you. What's the purpose of your documentation? To show that you are observing, acting, and planning about your patient. If your documentation does this completely and accurately -- and legibly-- you're doing fine.

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Specializes in Emergency Nursing.

I was instructed that it is completely inappropriate to chart "Will continue to monitor." That's your job! To monitor the status of your assigned patients and their response to treatments. That's what I have been instructed at least. Which makes complete sense.

D: Patient Bleeding Profusely

A: Told patient to stop bleeding.

R: Patient still bleeding. Will continue to monitor.

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