inguinal hernia repair icp for web
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Name
Hosp no
DOB
Affix patient label
Ward
Inguinal hernia repair integrated carepathway (ICP)Inclusion criteria
Patients undergoing inguinal hernia repair aged under 3 months corrected gestational age
Instructions for using this ICP
The ICP incorporates the detail and information required for this patient journey/episode together with
specific activities and variance tracking, which compares planned and actual care.
When activities are completed the practitioner should initial in the “met” box and enter the date and time in
the adjacent boxes.
In the event of variance from the plan or if an activity is not met, the practitioner should initial the “not met”
box, enter the date and time and complete the variance tracking at the foot of the page.
Important
Each professional making an entry in this record must complete the signature sheet on page 2, after which
they should use only initials when making an entry.G O S H T r u s
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IN F O R M A T
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Signature sheet
Name Designation Signature Initi als Date
Abbreviations and glossary of terms used in ICP
Abbreviation Term in full
FBC Full blood count
U&E Urea and electrolytes
G&S Group and saveCNS Clinical nurse specialist
NBM Nil by mouth
EP Electronic prescribing
CEWS Children’s early warning scoreG O S H T r u s
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Pre-admission assessment - Complete prior to or on day of admiss ion
Day shif t
Date:
Night shift
Date:Met Not
met
N/A Met Not
met
N/AID Activity
Enter initials/time Enter initials/time
0001 Confirm child and family understanding of reason for admission
0002 Complete assessment using Family Form 2, Patient Assessment Form, Birth History and Immunisation History
forms
0003 Confirm any allergies and document
0004 Identify any specific needs of child (disability, cultural orlanguage) and make arrangements for those to be met during
stay – record on page 3
0005 Check that details on PiMS are correct including next of kin and
parental responsibility0006 Admit child onto EP
0007 Ensure that family have been given appropriate writteninformation about the procedure if available
0008 Continue consent procedure with child and family
0009 Record weight and height/length and add to EP
0010 Record baseline temperature, pulse, respirations, bloodpressure and oxygen saturation
0011 Complete pressure area care assessment
0012 Complete moving and handling assessment
0013 Complete baseline pain assessment
0014 Inform parents/carers about what to do with regular
medications on day of surgery0015 Confirm admission and fasting times with family
0016 Advise parents to ensure supply of pain relief at homeG O S H T r u s
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Outcomes for episode
Day shift Night shift
Met Notmet
N/A Met Notmet
N/AID Activity
Enter initials Enter initials
X0001 All records for child available and up to dateX0002 Child and family understand reason for procedure
X0003 Parent understanding of fasting instructions confirmed
Notes
G O S H T r u s
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Between pre-operative assessment and night before admission
Day shif t
Date:
Night shift
Date:Met Not
met
N/A Met Not
met
N/AID Activity
Enter initials/time Enter initials/time
0017 Send other outstanding test results to consultant/team
0018 Arrange accommodation for one parent/carer
0019 Arrange transport if required
0020 Ensure notes are available and up to date
Outcomes for episode
Day shift Night shift
Met Not
met
N/A Met Not
met
N/AID Activity
Enter initials Enter initials
X0004 All test results required seen by consultant/team
Night before admission
Day shif tDate:
Night shiftDate:
Met Not
met
N/A Met Not
met
N/AID Activity
Enter initials/time Enter initials/time
0021 Contact family to confirm that child is well and bed is available
0022 Confirm medications to take on day of procedure with family
0023 Confirm and check family understanding of fasting instructions
Outcomes for episodeG O S H T r u s
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Notes
G O S H T r u s
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Day of admission – Pre-procedural care
Day shif t
Date:
Night shift
Date:Met Not
met
N/A Met Not
met
N/AID Activity
Enter initials/time Enter initials/time
0024 Check child and family understanding of reason for admission0025 Explain outline plan for stay to child and family
0026 Ensure assessment using Family Form 2, Patient AssessmentForm, Birth History and Immunisation History forms has been
completed previously and record any additional information
and/or changes since completion at assessment
0027 Confirm that fasting has been completed as per protocol
0028 Complete consent process and ensure that person withparental responsibility has signed consent form
0029 Complete surgical site marking documentation0030 Attach patient identification wristband to child and explain its
importance to child and family
0031 Carry out baseline observations (temperature, pulse,respirations, blood pressure and oxygen saturation) and record
0032 Repeat nose and throat swabs if child has attended another
healthcare facility since last assessment0033 Admit child onto EP
0034 Measure height and weight and add to EP
0035 Check blood test results and transcribe to pre-operativechecklist
0036 Complete pre-operative checklist
0037Review by anaesthetist
0038 Pre-medication prescribed and given if appropriate
0039 Accompany child to theatre
0040 Accompany parent/carer to post-operative ward
0041 Commence discharge planning using checklist on page 14G O S H T r u s
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Outcomes for episode
Day shift Night shift
Met Notmet
N/A Met Notmet
N/AID Activity
Enter initials Enter initials
X0007 All records for child available and up to dateX0008 Child confirmed prepared for anaesthetic and procedure
X0009 Child and family understand reason for procedure
X0010 Family have given informed consent
Notes
G O S H T r u s
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IN F O R M A T
I O N O N L Y
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Operation report
Nature of operation
Date and time carri ed out / / at :
Surgeon Sign Print
Assi st ant
Anaesthetis t
Report
Prophylactic antibiotics prescribed: None 1 dose co-amoxiclav 3 doses co-amoxiclav
G O S H T r u
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Day of admission - post-procedural care
Day shif t
Date:
Night shift
Date:Met Not
met
N/A Met Not
met
N/AID Activity
Enter initials/time Enter initials/time
0043 Handover received from recovery nurse
0044 Bedside oxygen and suction checked and functioning
0045 Explain plan of care to family and negotiate care requirements
0046 Meet child and family and update on procedure
0047 Review by surgical team including medications and pain relief
0048 Commence oral feeds
0049 Record temperature, pulse, respirations and oxygensaturations half-hourly for 2 hours then hourly (blood pressure if
required)
0050 Record pain scores as per protocol
0051 Check wound site hourly for 2 hours and then 4 hourly
0052 Check intravenous sites hourly
0053 Record strict fluid intake/output on fluid balance chart
0054 Assist with basic hygiene needs
0055 Medical handover sheet updated as necessary
0056 Nursing handover sheet updated as necessary
0057 Support patient and family
0058 Continue discharge planning using checklist on page 14
G O S H T r u
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Outcomes for episode
Day shift Night shift
Met Notmet
N/A Met Notmet
N/AID Activity
Enter initials Enter initials
X0011 Observations within CEWS acceptable rangesX0012 Pain adequately controlled
X0013 No sign of immediate wound complications
X0014 Child and family updated on procedure
X0015 Feed is available on the ward
Notes
G O S H T r u
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Post-procedure day 1
Day shif t
Date:
Night shift
Date:
Met Not
met
N/A Met Not
met
N/AID Activity
Enter initials/time Enter initials/time
0059 Child assessed at beginning of shift with bedside handover
0060 Bedside oxygen and suction checked and functioning
0061 Explain plan of care to family and negotiate care requirements
0062 Review by team including medications and pain relief
0063 Record temperature, pulse, respirations and oxygensaturations 4 hourly (blood pressure if required)
0064 Record pain scores as per protocol
0065 Check wound site 4 hourly
0066 Record strict fluid intake/output on fluid balance chart
0067 Support patient and family
0068 Complete discharge planning using checklist on page 14
0069 Ensure cannulas removed
0070 Complete discharge notification and send to all relevant parties
Outcomes for episode
Day shift Night shift
Met Not
met
N/A Met Not
met
N/AID Activity
Enter initials Enter initials
X0016 Child discharged safely
X0017 Discharge notification completed
NotesG O S H T r u
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Discharge checklist
Predicted date of discharge Discharged to
Yes No Details Initials
Transport
Medication
Prescribed
Collected
Explained
Equipment
Ordered Delivered
Explained
Teaching
Follow up arrangements
Discharge contact madeG O S H T r u
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The sequence of events, prompts and recommendations contained in this ICP are not intended to replace the professional judgement of individual clinicians. Staff shoulduse their knowledge, experience and assessment of the child as a basis for variance from this plan.
Page 15 of 16
Name
Hosp no
DOB
Affix patient label
Variance tracking recordInstructions for use
Each time a task is not met, the variance should be recorded in the table below. This page should be photocopied and used for variance analysis
Date Time ID What occurred? Why? What did you do about it? Outcome Initials
Example31/11/08 10am 0013 Parents not given written
informationComputer network down File copy requested Parents given written
information JB
( c ) G O S
H T r u s t 2 0
1 1
F O R I N F O
R M A T I O N
O N L Y
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The sequence of events, prompts and recommendations contained in this ICP are not intended to replace the professional judgement of individual clinicians. Staff shoulduse their knowledge, experience and assessment of the child as a basis for variance from this plan.
Page 16 of 16
Name
Hosp no
DOB
Affix patient label
Date Time ID What occurred? Why? What did you do about it? Outcome Initials
Example31/11/08 10am 0013 Parents not given written
informationComputer network down File copy requested Parents given written
information JB
( c ) G O S
H T r u s t 2 0
1 1
F O R I N F O
R M A T I O N
O N L Y