Arizona Physical Therapy Jurisprudence Practice Exam

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What must a supervising PT do if an individual other than a PT or PTA makes an entry into a patient's record?

  1. Ignore the entry

  2. Co-sign the entry

  3. Revoke the person's access to the record

  4. Document a separate correction

The correct answer is: Co-sign the entry

When a supervising physical therapist (PT) is confronted with an entry made by someone other than a PT or physical therapist assistant (PTA) in a patient's record, the most appropriate and responsible action is to co-sign the entry. This is vital because co-signing indicates that the supervising PT has reviewed and accepts the information as part of the patient's record. By co-signing, the supervising PT takes responsibility for the accuracy and appropriateness of the entry, ensuring that all information follows the required standards for documentation in healthcare. This practice also maintains the integrity of the patient’s records, which is crucial for continuity of care, legal compliance, and quality documentation practices within the healthcare system. The act of co-signing reinforces accountability and oversight, enhancing patient safety and the therapeutic process. It ensures that the supervising PT remains in control of the documentation process and can provide necessary corrections or clarifications if the entry is found to be erroneous or misleading.