What action should be taken when deeming a person a patient?

Documenting findings in the Patient Care Report (PCR) is crucial when deeming a person a patient. This documentation serves multiple important purposes: it provides a legal record of the patient's condition and care, improves continuity of care by ensuring that all healthcare providers have access to the same information, and supports quality assurance processes. The PCR indicates the assessments made, interventions performed, and the patient’s response, which is essential for ongoing treatment and evaluation.

Furthermore, thorough documentation is vital for meeting legal and institutional requirements, enabling accurate billing, and facilitating further medical evaluations. By capturing detailed information, you uphold professional standards and enhance patient safety. This practice aligns with principles of accountability in healthcare, ensuring that every patient’s care is systematically recorded and available for review as needed.