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CERTIFIED RELEASE OF INFORMATION SPECIALIST COMPLETE QUESTIONS AND VERIFIED ANSWERS

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CERTIFIED RELEASE OF INFORMATION SPECIALIST COMPLETE QUESTIONS AND VERIFIED ANSWERS

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Outpatient (OP)


Admission type


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A patient received treatment or testing at the hospital but never occupies a
bed. The episode of care is usually less than 24 hours at a time and can be
spread out over days, weeks even months.




Emergency Room (ER) or Emergency Department (ED)


Admission type


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, A patient enters the hospital by way of ER or ED receives treatment, release
usually within a matter of hours. This visit to the ER is usually unplanned and
is usually of an urgent nature.

Due to nature of the illness pt, required treatment, be admitted into the
hospital. Admission is then classified as Inpatient rather than ER. Orginal ER
Record becomes part of the Inpatient Record.




Consultation


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Handwritten or transcribed report of examination and recommendations
by the consulting physician.




Nurse's Notes


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Daily notes the document the patient's progress or decline during a
hospital admission. These usually include temperature, weight, blood
pressure, pain measurement and general observations by the nursing staff.
The notes may also be contained on large foldout sheets for 24 hours
nursing documentation in either the Intensive Care (ICU) or Cardiac Care
Unit (CCU).




Medication Sheets


Reports


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