Gmc Medical Record Keeping

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Good medical practice-english - General Medical …

https://www.gmc-uk.org/-/media/documents/good-medical-practice%2D%2D-english-20200128_pdf-51527435.pdf?la=en&hash=DA1263358CCA88F298785FE2BD7610EB4EE9A530

General Medical Council | 09 Record your work clearly, accurately and legibly 19 Documents you make (including clinical records) to formally record your work must be clear, accurate and legible. You should make records at the same time as the events you …

Keeping records - ethical guidance summary - GMC

https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/protecting-children-and-young-people/keeping-records

Keep clear, accurate and legible records. Make records at the time the events happen, or as soon as possible afterwards. Record your concerns, including any minor concerns, …

Recording decisions - decision making and consent - GMC

https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/decision-making-and-consent/recording-decisions

Keeping patients’ medical records up to date with key information is important for continuity of care. Keeping an accurate record of the exchange of …

Storing and disposing of recordings - ethical guidance

https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/making-and-using-visual-and-audio-recordings-of-patients/storing-and-disposing-of-recordings

The NHS Code of Practice Records Management Code of Practice for Health and Social Care (Information Governance Alliance, 2016); Records Management: NHS Code of …

Maintaining and improving standards of care - ethical …

https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/leadership-and-management-for-all-doctors/maintaining-and-improving-standards-of-care

General Medical Council (2017) Confidentiality: good practice in handling patient information London, GMC, paragraphs 128 - 130 (Records management and retention). 46 You must …

Medical record keeping: clarity, accuracy, and timeliness …

https://www.bmj.com/content/348/bmj.f7716

Wedad Abdelrahman and Abdelrahman Abdelmageed explain why it is important that these records are well maintained. Medical records are a fundamental part …

Retrospective records - Medical Defence Union

https://mdujournal.themdu.com/issue-archive/issue-6/retrospective-records

The GMC advises in paragraph 19 of 'Good medical practice ' (2013) that, 'Documents you make (including clinical records) to formally record your work must be clear, accurate …

Generic medical record keeping standards | RCP London

https://www.rcplondon.ac.uk/projects/outputs/generic-medical-record-keeping-standards

Data recorded or communicated on admission, handover and discharge should be recorded using a standardised proforma. Every entry in the medical record …

Good Record Keeping - Medical Defence Union

https://www.themdu.com/~/media/Files/MDU/Publications/Guides/UPDATED%20Consultant%20pack/B4%20Good%20record%20keeping.pdf

In a clinical context, records are essential and, Good Medical Practice (2013), outlines your responsibilities. The GMC explains that in providing care, you must keep clear, accurate, …

1.3 Record your work clearly, accurately and legibly

https://www.rcseng.ac.uk/standards-and-research/gsp/domain-1/1-3-record-your-work-clearly-accurately-and-legibly/

Ensure that all medical records are accurate, clear, legible, comprehensive and contemporaneous and have the patient’s identification details on them. Ensure that when …

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