Situation: A 64-year-old woman with liver cirrhosis is admitted to the medical ward because of vomiting and increasing abdominal girth. The ward writes its nursing notes in focus charting and uses charting by exception on its assessment flow sheets. Its electronic health record keeps an audit trail that shows when each entry was written. In the focus charting format used on the ward, each note has three parts labeled D, A and R. What does the nurse record under R?

Focus charting (DAR) records Data, Action, and Response about a focus, which may be a client concern or strength, not only a problem. Response describes the client's reaction to the nurse's action, closing the loop of each note.

Understanding the DAR format

Focus charting organizes each note around a single focus, which can be a client concern, a change in condition, or even a strength. The note itself has three labeled parts: D for Data, A for Action, and R for Response.

The R component closes the loop of the nursing process within that single note. After the nurse documents objective and subjective findings under D and the interventions performed under A, the R section records how the client actually reacted to those nursing actions. For this patient with liver cirrhosis, an example would be documenting that after antiemetic administration and abdominal girth measurement, the vomiting subsided and the client reported less nausea.

Key point! The R is not a plan for the future, a recommendation to another nurse, or a summary of lab values. It is the evaluation of the client's response to the specific action just documented in that same note.

DAR component	What it contains	Example for this patient
D (Data)	Subjective and objective findings that support the focus	Client vomited twice this shift; abdominal girth increased from 92 cm to 96 cm
A (Action)	Nursing interventions performed	Administered prescribed antiemetic; repositioned to semi-Fowler's; measured abdominal girth
R (Response)	Client's reaction to the action taken	No further vomiting for 2 hours; client states nausea is reduced

Watch out! Do not confuse the R in DAR with the R in SOAP charting. In SOAP, R stands for Revision or Response to treatment in some settings, but in focus charting, R consistently means the client's response to the nursing action documented under A.

The audit trail feature of the electronic health record mentioned in the scenario is relevant to documentation integrity, but it does not change what belongs under each DAR heading. Accurate documentation of the client's response is essential for evaluating whether nursing interventions were effective and for guiding subsequent care decisions, which supports continuity of care and patient safety ^[1]. When nurses document the response clearly, the next clinician can immediately see whether the action worked without having to infer it from raw data alone.