Focus Charting of F-DAR is intended to make the client and client 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. Three columns are usually used in Focus Charting for documentation: Date and Hour, Focus, and Progress Notes. The progress notes are organized into (D) data, (A) action, and (R) response, referred to as DAR (third column).

Here is an example of a format of Focus Charting or F-DAR

Date/Hour	Focus	Progress Notes
3/7/2010 8:00pm	Focus of care, this may be: a nursing diagnosis a sign or a symptom an acute change in the condition behavior	Data Action Response

The Data Category

The data category is like the assessment phase of the nursing process. It is in this category that you would be writing your assessment cues like: vital signs, behaviors, and other observations noticed from the patient. Both subjective and objective data are recorded in the data category.

The Action Category

The action category reflects the planning and implementation phase of the nursing prosess and includes immediate and future nursing actions. It may also include any changes to the plan of care.

The Response Category

The response category reflects the evaluation phase of the nursing process and describes the client’s response to any nursing and medical care.

Examples

Pain

The focus of this problem is pain. Notice the way the D,A,R were written.

Date/Hour	Focus	Progress Notes
5/20/2010 8:00pm	Pain	D: >Reports of sharp pain on the abdominal incision area with a pain scale of 8 out of 10 >Facial grimacing >Guarding behavior >Restless and irritable A: >Administered Celecoxib 200mg IV >Encouraged deep breathing exercises and relaxation techniques >Kept patient comfortable and safe R: >Patient reports pain was relieved

Hyperthermia

Date/Hour	Focus	Progress Notes
5/20/2010 8:00pm	Hyperthermia	D: >Temperature of 38.9 ^OC via axilla >Skin is flushed and warm to touch A: >Tepid Sponge Bath (TSB) done 7:30pm>Administered 250mg IV Paracetamol as per doctor’s order >Encouraged adequate oral fluid intake >Encouraged adequate rest R: 10:00pm>Temperature decreased from 38.9 to 37.1 ^OC

Another Variation

This is DAR made by Jay-D Man of Slideshare.net. with some modifications made. This is a very good variation.

F1: Ineffective Breathing Pattern
D1: increase respiratory rate of 24 cpm
D2: use of accessory muscle to breath
D3: presence of nonproductive cough
F2: Hyperthermia
D1: skin warm and flush to touched
D2: increased body temperature of T= 38.9 degree celsius/axilla
F3: Fatigue
D1: less movement noted
A: 9:00am
monitored v/s and charted
regulated IVF and charted
morning care done
assessed patient needs and performed handwashing before handling the patient
advised SO to always stay on patient bedside
promote proper ventilation and a therapeutic environment
elevated the head of the bed (moderate high back rest)
provided comfort measures and provide opportunity for patient to rest
due meds given

9:30am
tepid sponge bath done
instructed SO to provide blanket and let patient wear loose clothing

F4: Discharge Plan (12:00nn)
D1: discharged order given by Dr.Name/Time

M – advised SO to give the ff. meds at the right time, dose, frequency and route
E – encouraged to maintain cleanliness of the house and surroundings
T – advised to go to follow-up consultations on the prescribed date
H – encouraged to do chest tapping to facilitate mobilization of secretion
O – observed for signs of super infections such as fever, black fury tongue and foul odor discharges
D – encouraged to eat fresh vegetables and fish
S – advised to continue praying to God and hear mass on Sunday

2:00pm – out of the room per wheelchair with improved condition