What % of your coworkers falsify EMS documents ?

[crotchitymedic1986]

Before you say zero, consider these common falsifications:

1. Stating you checked equipment on a checklist that you didnt check.
2. Documenting more sets of vital signs than you actually took.
3. Changing the "times" for treatments during a cardiac arrest so that they match the protocol.
4. Documenting a "patient refusal" when you really talked them out of going to the hospital by EMS.
5. Documenting a treatment that you did not do (a glucose reading).
6. Falsifying your actual enroute time during sleep hours.
7. Documenting there was no patient when there was one at the scene.
8. Falsified an incident report to protect yourself or a partner (yes we had a backer on the ground).

 

[BossyCow]

Before you say zero, consider these common falsifications:

1. Stating you checked equipment on a checklist that you didnt check.
2. Documenting more sets of vital signs than you actually took.
3. Changing the "times" for treatments during a cardiac arrest so that they match the protocol.
4. Documenting a "patient refusal" when you really talked them out of going to the hospital by EMS.
5. Documenting a treatment that you did not do (a glucose reading).
6. Falsifying your actual enroute time during sleep hours.
7. Documenting there was no patient when there was one at the scene.
8. Falsified an incident report to protect yourself or a partner (yes we had a backer on the ground).

On our reports it states "All times approximate" so the times aren't 'falsified but sometimes put in after the fact to our best recollection of events. The rest of the list you wrote would be firing offenses in any agency I've worked with.

 

[crotchitymedic1986]

Just because it is a firing offense, doesnt mean that it doesnt happen.

 

[BossyCow]

Just because it is a firing offense, doesnt mean that it doesnt happen.

True.. but it doesn't happen twice.

Seriously, I don't know of anyone in either of the two agencies I'm affiliated with that would do any of the infractions you describe. I'm sorry if you are not affiliated with an agency that holds their employees to a similar high standard.

 

[reaper]

None, Zero, Nadda!

As told before, You'd be an idiot to answer this question on a public forum.

 

[JPINFV]

At the company where I used to work we were required to get 2 sets of vitals on all transports, even if the transport was, say, 0.4 miles. A lot of people documented the same set of vital signs twice (e.g. [time] [pul] [reps] [BP]: 1300, 70, 20, 120/70. 1300, 70, 20, 120/70.) claiming that they weren't falsifying anythng since it's the same set. "Besides, it's not like a discharge is going to change any over 4 minutes." Personally, I'd rather get called on not taking enough V/S than cooking the books to make it look like I did.

 

[rescuepoppy]

On our reports it states "All times approximate" so the times aren't 'falsified but sometimes put in after the fact to our best recollection of events. The rest of the list you wrote would be firing offenses in any agency I've worked with.

As Bossy said on our reports it says the same thing so if you miss it by a couple of minutes that is not bad. But on everything else you have to be accurate or else you will be on the outside looking in. As for checking in route dispatch has that time and knows if you are in the truck or not by the tattle-tale" beeps of the radios also can be tracked by gps so hard to falsify that. I will not take a truck without checking that all equipment and supplies are on it. No medic who cares about their patients or their job would knowingly falsify documents. If they do they have no place in this business.

 

[Sasha]

At the company where I used to work we were required to get 2 sets of vitals on all transports, even if the transport was, say, 0.4 miles. A lot of people documented the same set of vital signs twice (e.g. [time] [pul] [reps] [BP]: 1300, 70, 20, 120/70. 1300, 70, 20, 120/70.) claiming that they weren't falsifying anythng since it's the same set. "Besides, it's not like a discharge is going to change any over 4 minutes." Personally, I'd rather get called on not taking enough V/S than cooking the books to make it look like I did.

WE have some similar transports. Some people's reports pop up like this:
1300 70, 20, 120/70,
1305 72, 20, 122/68
And they never took a second set of vitals but falsified them completely. Sucks some people are too darn lazy.

 

[jochi1543]

1. Stating you checked equipment on a checklist that you didnt check.

Don't get me started....my partner SOMEHOW always finishes his unit checks in 5 minutes - takes me 1-1.5 hours. The other day he was *****ing about how he does all the work and no one else ever lifts a finger and how I need to go do a unit check. I went in, and there was a splatter of dried up vomit on the cabinets that he had not cleaned up from a previous call I had attended - THREE DAYS PRIOR. All the cabinets he had supposedly "checked" were actually sealed SHUT with barf.

It's one thing to just not do something...but not do it and claim you did is just unacceptable.

 

[jrm818]

For stable BLS patients with very short transport times, I tend to do only one BP, retake a pulse real quick, and document the BP as 90/p, taken by strong radial pulse (takes about 90 mmHG to perfuse radial artery). I know it isn't very accurate, but with no other suspicious s/s and no change in mentation it's extremely unlikely that there was a clinically relevant change in BP. The ED is going to do one right as we walk in the door anyways.

 

[mikeylikesit]

I think that it is kind of hard to make it long in EMS by falsifying documents. Minor things like time give or take a minute is done by everyone, however once you start changing major things like vitals and history significantly it can create future problems for your department.

 

[medicdan]

It's true. Documentation Falsifications happen much more often then I think any administrator knows or cares to know about. It ranges from a service that I have seen that has allowed "Dr. Blackpen" to sign Med Necs (illegal!), to completely making up vitals, etc.

I have seen some things done that I have less of a problem with. For example, on stable dialysis or interfacility patients, I see some EMTs take vitals from the monitor (or dialysis machine), but then note where the vitals come from on the PCR (its hard on some specific patients to get to the Right arm in the truck, as shunts, etc sometimes make taking a BP in the left impossible). On emergencies, I try to include the triage vitals in my PCR (noting that they are from triage), especially if I only get 2 sets in the field.

When I was on a regular truck, I simplified my checkouts. Approx. once every two weeks I inventoried each cabinet, and sealed it myself (and signed the seals), then wrote all the expiration dates on a piece of tape. When I checked the truck out, all I had to do was check the seals (and restock then reinventory anything open), check and note any expiration dates, check the O2 and check for gloves. Every day, I would also test the AED and Suction (check batteries, pads, canister, etc). I know myself and my partner were the only ones who used this truck (it was the oldest on the lot), but we had things set up the way we liked them. If I found a cabinet sealed, but without one of our initials, we would open it and check it ourselves, then resign and seal. With this system, my truck checks took no longer than 15 minutes, but were complete. </rant>

It seems that recently, Medicare has cracked down on incomplete or improper documentation, and companies need to provide more information in order to be paid. Not too long ago, AMR was audited by Medicare and found to have many problems, so other private companies have tightened their own belts in response.

 

[mycrofft]

Medicare and others are going to get a lot harder, too.

Their case managers will be held to a steep, no, vertical standard, and will likewise hold you to it, to deny as many of your calls and charges as possible.
I document them as I sees 'em, and it gets me in trouble because others in my service don't. I might have to drop ths forum and go to "Janitorialservice life".

 

[Sasha]

I see some EMTs take vitals from the monitor (or dialysis machine), but then note where the vitals come from on the PCR (its hard on some specific patients to get to the Right arm in the truck, as shunts, etc sometimes make taking a BP in the left impossible).

We do that, too. It's not falsifying documents. We the post dialysis vitals from the sheet, and if it's going to be difficult to get one, slap the dialysis bp cuff on them while the other is trying to track down someone to sign their paperwork (Hard in certain dialysis places. We've had RN's even refuse to sign it.) and take a second set from the machine.

I was just talking to a coworker, apparently someone just got fired for falsifying their vitals. The patient refused to let him do a set (You know, the "Get away! *smack/slap/hit/punch*" of confused dementia patients.) so he just made one up instead of documenting that the patient wouldn't allow vitals

 

[vquintessence]

Really?

13 people so far have voted for "small percentage". So most everyone whom you work with including yourselves counts everyshift (even 8 hr): 24 4x4's, 12 2x2's, 12 electrode packets, 6 adult tegaderm, 3 10cc 20ga syringe, 3 5cc 20ga syringe, 3 3cc 22ga syringe, 3 1cc 24ga syringe, 3 10cc syringe, 6 4" IV extension, 6 10gtt, 6 500cc NS, 6 1L NS, 6 lactated ringers, 4 60gtt, 4 tourniquets, 6 10cc NS Injector, 10 20ga IV, 10 18ga IV, 5 22ga IV, 5 24ga IV, 5 16ga IV, 5 14ga IV, 20 alcohol pads, 3 betadine, etc etc etc (already beat this one to death. Sorry!). :wacko: Going with the OP question, declining to count even one thing like the 2x2's should go as fraud.

That's just about one cabinet of 4, let alone 2 first in bags, O2 bag, bench seat, LP12, suction (port and mount), and all the lovely OEMS (MA thing) required bed pan, towels, sheets, blankets and pillow cases.

This AM alone I spent 1 hour checking & restocking the truck on stupid things like being short six 20ga, there being 1 of 7 nebs, one albuterol and no atrovent in supply cabinet, short 2 vials Zofran in drug box, etc, etc.

/END RANT

Should we run a poll on how many people falsify anonymous online polls?

 

[Jon]

"falsifing" my enroute time? Nope. Might I go responding on portable before I get my boots on? Yes.


#7 - What is a PATIENT? Please define. PA Protocol 112:

2. If individual declines care, there is no evidence of injury or illness, and the involved person has no symptoms or signs of injury/ illness, then the EMS practitioner has no further obligation to this individual.

If they meet that definition, I don't get a refusal...because there is nothing for them to refuse.


#8 - You'd be a MORON to do that. A secret shared by more than 1 person = not a secret.

 

[daedalus]

At the company where I used to work we were required to get 2 sets of vitals on all transports, even if the transport was, say, 0.4 miles. A lot of people documented the same set of vital signs twice (e.g. [time] [pul] [reps] [BP]: 1300, 70, 20, 120/70. 1300, 70, 20, 120/70.) claiming that they weren't falsifying anythng since it's the same set. "Besides, it's not like a discharge is going to change any over 4 minutes." Personally, I'd rather get called on not taking enough V/S than cooking the books to make it look like I did.

As JP knows, in LA county private ambulance land, falsifying PCRs occurs everyday. In my observation it is more often falsified than not. This includes LA county fire "paramedics".

I do not take part in it.

 

[PapaBear434]

13 people so far have voted for "small percentage". So most everyone whom you work with including yourselves counts everyshift (even 8 hr): 24 4x4's, 12 2x2's, 12 electrode packets, 6 adult tegaderm, 3 10cc 20ga syringe, 3 5cc 20ga syringe, 3 3cc 22ga syringe, 3 1cc 24ga syringe, 3 10cc syringe, 6 4" IV extension, 6 10gtt, 6 500cc NS, 6 1L NS, 6 lactated ringers, 4 60gtt, 4 tourniquets, 6 10cc NS Injector, 10 20ga IV, 10 18ga IV, 5 22ga IV, 5 24ga IV, 5 16ga IV, 5 14ga IV, 20 alcohol pads, 3 betadine, etc etc etc (already beat this one to death. Sorry!). :wacko: Going with the OP question, declining to count even one thing like the 2x2's should go as fraud.

That's just about one cabinet of 4, let alone 2 first in bags, O2 bag, bench seat, LP12, suction (port and mount), and all the lovely OEMS (MA thing) required bed pan, towels, sheets, blankets and pillow cases.

This AM alone I spent 1 hour checking & restocking the truck on stupid things like being short six 20ga, there being 1 of 7 nebs, one albuterol and no atrovent in supply cabinet, short 2 vials Zofran in drug box, etc, etc.

/END RANT

Should we run a poll on how many people falsify anonymous online polls?

It's funny, because all the drug, IV, nebulizers, and things like that on our trucks are all in sealed boxes inside sealed cabinets. Only the ALS personnel have access to the cabinet, and if a box is open it is inventoried by a hospital pharmacy and swapped out for a new, sealed one. That cuts down on our inventory time a LOT.

 

[BossyCow]

/END RANT

Should we run a poll on how many people falsify anonymous online polls?

There is a HUGE difference between "Falsifying a report" and being careless or sloppy. Falsifying a report is knowingly writing down something that isn't true. Lying, stating facts not in evidence. The kind of behavior you talk about on your truck is sloppy but not 'falsifying' and if it is falsifying information and you are aware of it and do not file a report on your co-worker for the offenses listed, then you are not a bright shining star way above the slovenly standard set by your co-workers.. you are part of the problem. You are accepting the illegality of those on your shift.

I hate to hear people griping about the horrible things their co-workers are guilty of in forums like this, painting themselves as the big hero who does everything right. Allowing substandard care to exist without addressing it is just as bad as doing it yourself.

I stand by my original post. I do not know of anyone who falsifies a report, equipment check or other department document. If I was aware of it, that person and the report would be immediately brought up for disciplinary action up to and including dismissal. It cannot be allowed and cannot be tolerated.

 

[RESQ_5_1]

As far as inventory goes, everyone here replaces everything they use as soon as they get back. Complete rig inventories are done every week. Generally, on rig checks, we check O2 psi's, Entonox psi, expirations of all drugs, etc. We also check fluid levels and if all the lights are operational.

In the almost 2 years I have been here, I have only been caught short a couple of times. Both on my portable O2. And, both times because we got toned out before we could do a rig check. O2 seems to be the most prevalent problem at our station.