What is the correct action if a correction needs to be made in a patient record?

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When a correction needs to be made in a patient record, placing a single line through the mistake is the appropriate action. This method ensures that the original information remains legible while indicating that a correction has taken place. It provides clear documentation of what the previous entry was, which is crucial for both legal and clinical accountability. Initialing next to the correction can further validate the change, confirming that it was made by the provider accountable for the record.

Other methods such as erasing the mistake, recreating the entire document, or using white-out may lead to confusion or misinterpretation of the patient's record. Erasures can create ambiguity about what was originally recorded, while recreating the entire document may not reflect the historical accuracy of patient care. Using white-out eliminates the original information completely, which is not compliant with best practices in record-keeping, as it obscures the integrity of the information. Keeping accurate, transparent, and traceable records is essential for maintaining trust and adhering to legal standards in dental practice.

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