Center for Improvement in Healthcare Quality Newsletter
January 2022

CIHQ-ARS Blog

Block Charting to Meet Regulatory Requirements

By: Kim McGuire
Caring for a critically ill patient can be a whirlwind of activity and interventions, especially when there is an emergent situation caused by a change in the patient’s condition. There can be numerous team members working together to create a stable condition for the patient. Single or multiple medications being infused, quick changes in the patient’s condition and several treatment changes, medication dose and rate changes, all add up to an organized event that would seem like chaos to an outsider.
But how do you record the medication administration, the numerous titrations, the dosing, etc.? Well, this is where block charting may be an appropriate charting mechanism.
What is block charting?
  • Block Charting is a method of documenting that may be used when rapid titration of medication is necessary in a specific urgent or emergent situation. This must be defined in an organizational policy.
What is the time frame for block charting episodes?
  • A single block charting episode must NOT exceed a 4-hour time block. If a patient’s urgent or emergent situation extends past a 4-hour time period AND medication titration continues – a new block charting episode must be initiated.
What is required to be included in each block charting episode (each 4-hour time block)?
  • Initiation time of block charting episode
  • Medication(s) being administered during the block time
  • Beginning AND ending rates of medication(s) administered during the charting time block
  • The maximum rate (dose) of medication(s) administered during the charting time block
  • The time block charting was completed
  • Physiological parameters evaluated to determine titratable medication administration during the charting time block
Urgent and emergent care for a patient can be stressful. Utilizing the elements of block charting to document the medication(s) titration and meet regulatory requirements should not be stressful. Having a quick reference of the required elements of this documentation, like listed above, will not only support your organization with staff knowledge and understanding of the regulatory requirements, but will also support effective documentation practices.

References

Astle, S. & Czajkowski, C. Block Charting During Rapid Titration for the Critically Ill Patient, December 2020, aacn.org
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