Inguinal Hernia Repair ICP for WEB

8/18/2019 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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IN F O R M A T

I O N O N L Y


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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


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



Met Not

met

N/A Met Not

met

N/AID Activity


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


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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IN F O R M A T

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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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Day of admission – Pre-procedural care

Day shif t

Date:

Night shift

Date:Met Not

met

N/A Met Not

met

N/AID Activity


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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Met Notmet

N/A Met Notmet

N/AID Activity


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

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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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IN F O R M A T

I O N O N L Y


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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


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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IN F O R M A T

I O N O N L Y


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Met Notmet

N/A Met Notmet

N/AID Activity


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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IN F O R M A T

I O N O N L Y


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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


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



Met Not

met

N/A Met Not

met

N/AID Activity


X0016 Child discharged safely

X0017 Discharge notification completed

NotesG O S H T r u

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IN F O R M A T

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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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IN 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 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


16/16

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

Date post:	07-Jul-2018
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Inguinal Hernia Repair ICP for WEB

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