Purpose Statement

This article explains how to obtain, document, and manage electronic signatures within an electronic Patient Care Report (ePCR) in First Due.

Capturing signatures ensures that required acknowledgments, authorizations, and provider documentation are properly recorded as part of the patient care report. First Due allows users to capture patient and EMS provider signatures, document reasons when signatures cannot be obtained, and manage signatures according to their agency's requirements.

Background Information

The Signatures section of an ePCR allows EMS personnel to capture and document signatures associated with patient care.

Depending on your agency's configuration, different signature blocks and acknowledgment options may be available.

Common signature types include:

• Patient Signature: Documents patient acknowledgments, authorizations, or releases.

• EMS Provider Signature: Documents the signature of the EMS provider responsible for patient care.

• Additional Signatures: Other signature types required by your agency's policies and configurations.

Users can also document why a signature was not obtained, such as when a patient refuses to sign or is unable to provide a signature.

Important: Available signature blocks, signature reasons, and acknowledgment language may vary based on your agency's configuration.

Required Permissions

Users must have appropriate access to the ePCR and its signature functionality.

The following actions may be subject to agency-specific permissions:

• Accessing and completing an ePCR.

• Capturing patient and EMS provider signatures.

• Editing previously captured signatures.

• Deleting signatures.

Note: The exact First Due permission names for these actions have not been verified. Users should contact their agency administrator to confirm the permissions assigned to their role. Deleting signatures specifically requires appropriate permissions.

Video

Step-by-Step Guide

Step 1: Access the Signatures Section

1. Open the ePCR you are completing in First Due.

2. Navigate to the Signatures section of the report.

3. Verify that the crew member associated with completing the report is correct.

4. If the crew member needs to be changed, select the three-line menu to the right of the crew member information and make the appropriate selection.

Step 2: Select the Appropriate Signature Block

1. Within the Signatures section, review the available signature blocks.

2. Locate the Patient Signature block.

3. Select the plus (+) button to add a new patient signature.

4. The signature entry fields will appear.

Note: Your agency may have different signature blocks or requirements than those displayed in this example.

Step 3: Identify the Person Signing

1. Locate the field identifying the type of person providing the signature.

2. Verify that Patient is selected when obtaining a patient signature.

3. Choose the appropriate signer type from the available options.

Step 4: Select the Signature Reason

1. Scroll down to locate the Reason for Signature field.

2. Select the appropriate reason from the available options.

3. For this example, select HIPAA Acknowledgment and Release.

4. Verify that the selected reason accurately represents the acknowledgment or authorization being documented.

Note: Available signature reasons depend on your agency's configuration.

Step 5: Enter the Signature Date and Time

1. Locate the Date and Time of Signature field.

2. Enter the date and time using one of the following methods:

• Manual Entry: Type the date and time directly into the field.

• Calendar: Select the calendar icon to choose the appropriate date and time.

• Stopwatch Icon: Select the stopwatch icon to automatically populate the current date and time.

3. Verify that the recorded date and time accurately reflect when the signature was obtained.

Step 6: Capture the Patient Signature

1. Scroll down to the signature capture area.

2. Select + Sign to open the signature capture window.

3. Have the patient review the displayed acknowledgment or release information before signing.

4. Ask the patient to provide their signature using their finger or an appropriate pen or stylus on the signature area.

5. Review the captured signature.

6. If the signature needs to be redrawn, select Draw Again and have the patient sign again.

7. Once the signature is acceptable, select Save.

Step 7: Document a Reason When a Signature Cannot Be Obtained

If the patient is unable or unwilling to provide a signature, document the reason instead.

1. Within the patient signature entry, locate the No Signature Reason toggle.

2. Enable the toggle to indicate that a signature was not obtained.

3. Locate the field for selecting the reason a signature could not be captured.

4. Choose the appropriate reason from the available options. Examples demonstrated include:

• Patient refusal

• Patient unconscious

• Patient visually impaired

5. Verify that the selected reason accurately reflects the circumstances.

6. Select Save to record the information.

Important: Document the actual reason a signature was not obtained. Follow your agency's policies regarding signature refusals, inability to sign, and any additional documentation requirements.

Step 8: Capture an EMS Provider Signature

1. Return to the Signatures section of the ePCR.

2. Locate the EMS Provider Signature block.

3. Select the plus (+) button to add a provider signature.

4. Complete the applicable fields, including the crew member and provider name.

5. Enter any additional information required by your agency.

6. Navigate to the signature capture area.

7. Depending on your agency's configuration, you may see one or both of the following options:

• Sign: Capture the EMS provider's signature.

• Fill: Use the alternative signature completion option when enabled by your agency.

8. Complete the signature using the available method.

9. Select Save to record the EMS provider signature.

Step 9: Verify Captured Signatures

1. Return to the main Signatures section.

2. Review the signature blocks that have been completed.

3. Confirm that successfully captured signatures display a green signed indicator.

4. Review any additional signature blocks required by your agency.

5. Complete any remaining required signatures before finalizing the report.

Step 10: Edit or Delete an Existing Signature

1. Navigate to the Signatures section of the ePCR.

2. Locate the previously captured signature that requires modification.

3. Open the existing signature entry.

4. Make the necessary changes and save the updated information.

5. If a signature must be removed, use the available delete option, provided your assigned permissions allow it.

Important: Deleting signatures may be restricted based on your agency's permissions and policies.

Step 11: Continue Completing the ePCR

1. Verify that all agency-required signature blocks have been addressed.

2. Confirm that each captured signature or documented no-signature reason is accurate.

3. Return to the remaining sections of the ePCR.

4. Continue completing the patient care report according to your agency's documentation requirements.

Best Practices

- Verify the Crew Member: Confirm that the correct crew member is associated with the report before capturing signatures.

- Review Acknowledgments: Allow patients to review the applicable acknowledgment or release information before signing.

- Select Accurate Signature Reasons: Ensure the reason selected matches the purpose of the signature.

- Use Accurate Timestamps: Confirm the signature date and time, especially when entering information manually.

- Document Missing Signatures: When a signature cannot be obtained, select the appropriate no-signature reason rather than leaving the situation undocumented.

- Review Signatures Before Completion: Verify that required signature blocks have been completed and display the appropriate status.

- Follow Agency Requirements: Signature types, acknowledgment language, and completion requirements may differ between agencies.

- Use Caution When Editing or Deleting: Ensure that any modifications to previously captured signatures comply with your agency's documentation policies.

Troubleshooting & FAQs

Why don't I see the same signature blocks shown in the training video?

Signature blocks may vary depending on your agency's configuration. Contact your agency administrator if an expected signature block is missing.

How do I change the person providing the signature?

Within the signature entry, select the three-dot menu (⋮) next to the signer type and choose the appropriate option.

Can I automatically populate the signature date and time?

Yes. Select the stopwatch icon next to the date and time field to populate the current timestamp.

What should I do if the patient cannot provide a signature?

Enable the No Signature Reason toggle and select the appropriate reason, such as refusal or unconsciousness. Save the entry to document the circumstances.

Can a patient redraw their signature?

Yes. Before saving the signature, select Draw Again to clear the existing signature and allow the patient to sign again.

What is the difference between Sign and Fill?

The Sign option allows a signature to be captured. Some agencies may also have a Fill option available for EMS provider signatures. The availability and use of this option depend on agency configuration.

How do I know whether a signature was successfully captured?

After saving, return to the Signatures section. Completed signature blocks display a green indicator showing that they have been signed.

Can I edit a signature after it has been saved?

The demonstrated workflow allows users to return to an existing signature and make edits. Availability may depend on the report's state and agency permissions.

Why can't I delete a signature?

Deleting signatures requires appropriate permissions. If the delete option is unavailable, contact your agency administrator to verify your access.

Do I need to obtain every signature displayed in the ePCR?

Signature requirements are determined by your agency. Review your department's policies to identify which signatures must be obtained or otherwise documented before completing the report.