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record |
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record(1) Pronounced "reck-erd," a group of related fields that store data about a subject (master record) or activity (transaction record). A collection of records make up a file. record 1. a written account of some transaction that serves as legal evidence of the transaction 2. a written official report of the proceedings of a court of justice or legislative body, including the judgments given or enactments made 3. a list of crimes of which an accused person has previously been convicted, which are known to the police but may only be disclosed to a court in certain circumstances 4. have a record to be a known criminal; have a previous conviction or convictions 5. a thin disc of a plastic material upon which sound has been recorded. Each side has a spiral groove, which undulates in accordance with the frequency and amplitude of the sound. Records were formerly made from a shellac-based compound but were later made from vinyl plastics 6. Computing a group of data or piece of information preserved as a unit in machine-readable form 7. (in some computer languages) a data structure designed to allow the handling of groups of related pieces of information as though the group was a single entity
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The chapter's focus on the patient through the use of the elements in a problem-oriented record is of great value. Consider how the term subjective has become distorted in some uses of the problem-oriented record or with SOAP (subjective, objective, assessment, plan) notes. [13] Feitelberg SB: The Problem-Oriented Record System in Physical Therapy. |
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