Guidance for completing patient care records

Clinical   kit pic

Completing a patient care record (PCR) is a vital part of everyday working for a majority of us.

It is important to remember the following points when completing a PCR:

  • Keep the top copy of the paper PCR and send to a locality office, in accordance with the PCR policy
  • Mark any ECGs printed with the CAD number, and securely attach to the completed shift log summary to ensure we can track any ECGs required by a coroner etc.
  • Remember to fill out the unique form number on the shift log summary, and place it with the top copy of the PCR inside a clear plastic wallet; please don’t staple the two together
  • Send paper PCRs to the medical records departments within two weeks of being created. This will ensure that any records required for ambulance clinical quality indicators (ACQIs) are included in your monthly results. Any that arrive too late can’t be used which means you may not have a true picture of the care being delivered in your area.

The policy for PCRs can be found on our website.

Published 1st October, 2016

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