As a nurse, understanding focus charting or F-DAR charts is important for accurately tracking patients’ health progress. These charts offer a structured approach to patient documentation that enhances clarity, communication, and continuity of care in healthcare settings. By learning about the components of F-DAR charts, nurses can effectively record information to ensure patients receive optimal care.
Focus Charting of F-DAR is one of the many documentation and recording methods that is intended to make the client and client’s concerns and strengths the focus of care. It is a method of organizing health information in an individual’s record. Focus charting is a systematic approach to documentation.
The following are the advantages of focus charting:
1. Flexibility. It can adapt to various clinical practice settings, whether it’s in hospitals, clinics, or long-term care facilities. This adaptability allows healthcare professionals to use focus charting regardless of the specific environment they work in.
2. Nursing Process Orientation. Focus charting centers on the nursing process, which includes assessment, planning, implementation, and evaluation. By following this systematic approach, nurses can provide comprehensive and individualized care to the patients.
3. Organized Data. Information in focus charting is structured and organized according to the focus, making it easier for healthcare professionals to find relevant data quickly.
4. Interdisciplinary Documentation. Focus charting fosters interdisciplinary documentation, promoting collaboration among healthcare team members to ensure comprehensive patient care is documented by all involved professionals.
5. Compatibility with computer-based documentation systems. Focus charting integrates smoothly with computer-based systems, streamlining documentation, enhancing data accessibility, and improving collaboration among healthcare teams, ultimately benefiting patient care delivery.
Three columns are usually used in Focus Charting for documentation:
1. Date and Time. The first column indicates when the documentation entry was made and specifies the exact time when an event, assessment, intervention, or observation occurred.
2. Focus (F). This is a statement of the central focus of the patient’s care. It could be a problem, a nursing diagnosis, a symptom, a treatment, or any other aspect that needs immediate attention.
3. Progress Notes. The progress notes are organized into (D) Data, (A) Action, and (R) Response, referred to as DAR (third column).
| Date/Time | Focus | Progress Notes |
|---|---|---|
| 3/7/2024 8:00 PM | Focus of care, this may be a nursing diagnosis, behavior, a sign or a symptom, significant event in the patient’s treatment, or an acute change in the behavior. | (D) Data: (A) Action: (R) Response: |
Listed below are examples of focus chartings for different problems.
The focus of this problem is hyperthermia. Notice the way how the D, A, and R are written.
| Date/Time | Focus | Progress Notes |
|---|---|---|
| 5/20/2023 7:10 PM | Hyperthermia | Data: – Patient reports feeling warm and flushed. – Temperature: 38.8ºC via axilla – Skin is warm and dry |
Action:
– Administered acetaminophen 650 mg orally as ordered.
-Applied cold compresses to forehead and axilla.
– Encouraged adequate fluid intake as tolerated.
| Date/Time | Focus | Progress Notes |
|---|---|---|
| 2/23/2024 9:00 AM | Acute postoperative pain | Data: – Patient reports a sharp pain in the abdominal incision area with a pain intensity of 8/10 on the numerical rating scale. – Vital signs within normal limits. – Surgical incision site red, swollen, and warm to touch. |
Action:
– Administered 50 mg IV tramadol as ordered.
– Provided ice pack for localized pain relief.
– Assisted patient in finding comfortable position and immobilized surgical sites as needed.
– Educated patient on deep breathing exercises and relaxation techniques.
Action:
– Changed dressing using aseptic technique.
– Assessed wound for any signs of dehiscence.
– Reinforced wound care instructions to the patient.
| Date/Time | Focus | Progress Notes |
|---|---|---|
| 07/18/2023 10:00 PM | Preventing falls in a high-risk patient. | Data: – Patient history of recurrent falls. – Weakness and unsteady gait noted during ambulation. – Environment assessed for fall hazards and non-slip socks applied. – Bed alarm activated, and call light placed within reach. |
Action:
– Implemented environmental modifications to reduce fall hazards (e.g., installing grab bars, improving lighting).
– Encouraged the use of assistive devices such as a walker or cane.
– Implemented hourly rounding to address patient needs and safety concerns.
– Educated patient on the importance of using call light for assistance.
Action:
– Assisted patient with ADLs and mobility activities as needed.
– Encouraged regular participation in physical therapy sessions to improve strength and range of motion.
– Educated patient on safe transfer techniques and the importance of using assistive devices.
| Date/Time | Focus | Progress Notes |
|---|---|---|
| 12/18/2021 11:00 PM | Agitation and aggressive behavior in a patient with dementia. | Data: – Patient pacing, shouting, and exhibiting combative behavior toward staff and other patients. – History of dementia with recent changes in behavior. – No signs of acute physical illness. |
Action:
– Engaged patient in calming activities such as listening to music and guided relaxation exercises.
– Provided reassurance and redirection.
– Implemented safety measures to prevent injury to self and others.
| Date/Time | Focus | Progress Notes |
|---|---|---|
| 09/15/2023 08:30 AM | Nutritional status and intervention for a malnourished patient. | Data: – Patient reports poor appetite and unintentional weight loss. – BMI: 17.5 kg/m², indicating underweight status. – Laboratory findings reveal hypoalbuminemia and low total protein levels. – Nutritional intake documented to be below recommended daily allowances. |
Action:
-Referred patient to a dietitian for comprehensive nutritional assessment and individualized meal planning.
-Initiated a high-protein, high-calorie diet and encourage frequent small meals and snacks.
-Monitored intake and output, weight, and laboratory values related to nutritional status.
Paul Martin R.N. brings his wealth of experience from five years as a medical-surgical nurse to his role as a nursing instructor and writer for Nurseslabs, where he shares his expertise in nursing management, emergency care, critical care, infection control, and public health to help students and nurses become the best version of themselves and elevate the nursing profession.
