What is the proper way to correct an error in a patient's paper chart?

The correct method for correcting an error in a patient's paper chart is to use a single strikethrough to void the error, then write the correction along with your initials and the date. This practice aligns with proper documentation standards and ethical guidelines in healthcare.

Using a single strikethrough allows the original entry to remain legible, which is crucial for maintaining the integrity of the patient’s medical record. This transparency is important for continuity of care and ensures that any changes can be traced back to the original entry. By placing your initials and the date next to the correction, you also provide accountability and denote exactly when the amendment was made, which is significant in legal and ethical contexts.

Maintaining an accurate and transparent record fosters trust between the patient and the healthcare provider and complies with regulations that govern patient record-keeping. This practice helps avoid confusion regarding the patient’s medical history and treatment plans, which is vital for delivering appropriate care.