Patient Detect Audit Analysis

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The chart I audited was a little tricky because the patient didn’t stay for a full treatment, and only received an assessment and desensitizing agent. This patient chart had many strengths and a few weaknesses. Overall, doing the chart audit emphasized the importance of careful documentation, and opened my eyes to things I may have not done. The main strength of the chart was that the clinician had very thorough and well-thought documentation. The clinician had taken radiographs on the patient, and all the correct forms were completed. Additionally, all the forms that needed to physically be in the paper chart were there and on the correct side. The EagleSoft documents and chart notes were filled out correctly, signed by the patient, and
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