Arizona Physical Therapy Jurisprudence Practice Exam

How must an error in a patient record be corrected?

1. By completely erasing the error

2. In a way that allows the erroneous information to remain legible

3. By writing a new record without any errors

4. By changing all references to the error

The correct answer is: In a way that allows the erroneous information to remain legible

The correct approach to correcting an error in a patient record is to do so in a manner that allows the erroneous information to remain legible. This ensures transparency and accountability in medical documentation. Maintaining the visibility of the original entry preserves the integrity of the patient’s record, which is essential in healthcare for various reasons, including legal protection, continuity of care, and the ability to track changes over time. Correctly documenting the error ensures that anyone reviewing the record can see what the original information was, understand the context of the correction, and avoid misunderstandings or misinterpretations in the future. This practice aligns with the principles of good documentation and risk management in the healthcare setting, where mistakes can have significant ramifications for patient care. Erasing the error completely would obscure the initial information, creating potential confusion and hindering the ability to trace back to the original entry, while drafting a new record without any errors does not provide context about the previous mistake. Similarly, changing all references to the error could lead to a loss of critical information that might impact treatment or legal matters.