395.3015 Patient records; form and content.—Each hospital operated by the agency or by the Department of Corrections shall require the use of a system of problem-oriented medical records for its patients, which system shall include the following elements: basic client data collection; a listing of the patient’s problems; the initial plan with diagnostic and therapeutic orders as appropriate for each problem identified; and progress notes, including a discharge summary. The agency shall, by rule, establish criteria for such problem-oriented medical record systems in order to ensure comparability among facilities and to facilitate the compilation of statewide statistics.
History.—ss. 26, 30, ch. 82-182; ss. 30, 98, ch. 92-289.
Note.—Former s. 395.016.
Section: Previous 395.10971 395.10972 395.10973 395.10974 395.10975 395.2050 395.301 395.3015 395.302 395.3025 395.3035 395.3036 395.3037 395.3038 395.3039 NextLast modified: September 23, 2016