Public Health Nursing Documentation Guidelines - Indian Health ...
Public Health Nursing Documentation Guidelines - Indian Health ...
Public Health Nursing Documentation Guidelines - Indian Health ...
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<strong>Documentation</strong> and Coding <strong>Guidelines</strong> for <strong>Public</strong> <strong>Health</strong> Nurses<br />
4.4 Review/Cover Sheet<br />
Figure 4.4 Activity Time<br />
The Review Tab offers an<br />
overview of patient information<br />
and is an excellent<br />
source of “one-stop shopping”<br />
in patient health information.<br />
<strong>Public</strong> health nurses can review<br />
the patient’s history,<br />
problem list and current medications.<br />
<strong>Public</strong> health nurses<br />
can also enter information on<br />
this tab, such as allergy information<br />
and vital signs.<br />
The next step is to fill in the Activity Time. See Figure 4.4. Depending on the local<br />
design template created by your clinical applications coordinator, your Activity Time<br />
may be located in the Review Tab or may be placed in another section. The design<br />
template can be changed to meet your department’s needs.<br />
Activity Time is divided into Travel Time and Encounter Time. Travel Time is the<br />
total time spent going to and from the patient’s site. Encounter Time is the face-toface<br />
time with the patient, plus any chart reviews, case management, documentation,<br />
etc., completed before and after the patient visit. (In a sense, encounter time is<br />
everything but travel time.) The EHR automatically totals the activity time. All<br />
times must be in minutes, not in hours.<br />
<strong>Indian</strong> <strong>Health</strong> Service Page 4-9
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