Course Overview
How to document risk, uncertainty and safety-netting clearly. Includes consent, capacity, safeguarding, statements and writing notes that stand up to scrutiny.
Learning Objectives
By the end of this course, participants will be able to:
- Write defensible clinical notes
- Document risk assessments and safety netting clearly
- Record capacity assessments legally
- Understand the legal implications of documentation
- Respond appropriately to complaints and coroner requests
Key Topics Covered
The purpose of medical records
Documenting negative findings and risk assessment
Safety netting: Specific vs generic
Consent and Capacity documentation
Retrospective notes and amendments
Writing statements for coroners/complaints
Who Should Attend
All Clinicians
Assessment Methods
- Documentation audit exercise
- Case scenarios
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Course Details
Duration
3 hours
CPD Credits
3 RCEM CPD hours
Delivery Format
- In-person
- Virtual
- Self-paced
Category
Governance & Professional Practice