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Chief Complaint (CC) • State the patient’s main reason for visit — concise and focused. • Use the patient’s own words in quotes (1–2 words or one short sentence). • Example: “Sore throat for two days.” or “Shortness of breath.” History of Present Illness (HPI) – OLDCARTS...

Age: 27 Sex: Male Race/Ethnicity: Hispanic Marital Status: Married Occupation: Construction worker Insurance: Private Living Situation: Lives with wife, mother, and 4-year-old son Chief Complaint (CC): Fever and body aches for three days. Patient Statement About three days ago I started feeling really run down, like I was...

A Medicare Cost Report (MCR) collects descriptive data, both financial and statistical in nature, to identify if a facility has been overpaid or underpaid for Medicare patients. The data is also utilized to set prospective payments. MCRs are in place for institutional providers not physicians...

What is the project question (PICOT)? In other words what are you ultimately trying to figure out? Address in P-I-C-O-T format first; then a narrative description. What is the title of your project? Be specific and concise. Who will benefit from your project? Where are the people located...

The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on...

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations. For example, the use of 12-hour shifts has been a strategy to...