全膝关节置换术临床路径 表单 Clinical Pathway

1、本文格式为Word版，下载可任意编辑 全膝关节置换术临床路径 表单 Clinical Pathway ? The State of Queensland (Queensland Health) 2022 Page 1 of 25 B I N D I N G M A R G I N D O N O T W R I T E Total Knee Arthroplasty Clinical Pathway K n e e A r t h r o p l a s t y P a t h w a y V 3.2 180707 M R C O 001 S W 229 Page 2 of 25 B I N

2、D I N G M A R G I N D O N O T W R I T E Total Knee Arthroplasty Clinical Pathway Facility: UR Number Family Name Given Names Date of Birth Sex M F Affix patient label here SIGNATURE LOG Every person documenting in this clinical pathway MUST supply a sample of their initials and signature below Sign

3、(Initial) Signature Print Name Role ? The State of Queensland (Queensland Health) 2022 Page 3 of 25 B I N D I N G M A R G I N D O N O T W R I T E Total Knee Arthroplasty Clinical Pathway Facility: UR Number Family Name Given Names Date of Birth Sex M F Affix patient label here Discharge Plan / Summa

4、ry MEDICAL Sign Date NURSING Sign Date Referral Source notified of discharge Support Person GP/Practice Support Person notified of discharge _hrs Referral Dr QAS booked 24hrs prior to discharge Referral Hospital Patient transported home by_ Discharge Letter Belongings and Valuables Returned Copy giv

5、en to patient Private X-rays, scans Sent to GP Faxed Mailed Patients own medication Walking aids Advice provided regarding Advice Return to normal activities Follow-up plan confirmed When to seek medical assistance Patient able to state signs / symptoms requiring presentation; temp / feels feverish

6、/ pain and or problems with wounds Emergency number _ given Post-op education and precautions stated Medical certificate / Travel documents Referrals Completed To _ booked Issued Follow-up Clip remover and Anti-embolic therapies given to patient In _ weeks Follow-up Appointment On _ / _ / _ Made and

7、 appointment card issued GP time:_ Will be posted OPD time:_ Patient will make their own booking Other:_ Not Required Discharge Medication Ordered MEDICATIONS Drug Profile print out provided for at risk patients Support Services Information provided re support services Discharge medications given to

8、 patient and educated re: regime PHYSIOTHERAPY Medication Discharge Summary provided to patient Independent and safe transfers / mobility Discharge Summary / Referral Form faxed to GP Home exercise programme provided Time faxed _ Active Flex to _ , Ext Lack_, SLR Y/N with _ lag OCCUPATIONAL THERAPY

9、Aid_ assist_, distance_, m, Stairs_ ? Appropriate ADL function for discharge or strategies in place TUG: _Sec. Standing valgus / varus : _ ? Understands impact of surgery on ADLs and home environment Physiotherapy referral to :- ? Discharge equipment / home mods in place & patient demonstrate approp

10、riate use. Occupational Therapy referral to:- By Whom_ Date_ Comments Comments K n e e A r t h r o p l a s t y P a t h w a y V 3.2 180707 M R C O 001 Page 4 of 25 B I N D I N G M A R G I N D O N O T W R I T E Total Knee Arthroplasty Clinical Pathway Facility: UR Number Family Name Given Names Date o

11、f Birth Sex M F Affix patient label here Clinical Pathway Knee Arthroplasty EXPECTED OUTCOMES Phase: 1 Assessment at Pre-Admission ? You can state the reason for admission, surgery and how long you will be in hospital. ? That all relevant investigations have been completed and the results reviewed.

12、Phase: 2 Pre- and Post-Operation ? After the results have been explained, you can state an understanding of the usual pre- and post-operative care routines, the surgery and its effects. ? Your pain will be in a range that is OK with you, both before and after your operation. ? As soon as you are ale

13、rt and orientated, you will not feel sick and can drink again. As soon as you are assessed as ready, you will also be able to eat. Phase: 3 Day 1 Post-Operative ? The Orthopaedic Surgical Team will have reviewed your progress. ? You will be drinking and eating normally now. Phase: 4 Day 2 7 Post-Ope

14、rative until ready for discharge ? The Orthopaedic Surgical Team will continue to review you daily and once you are ready, will suggest follow-up. ? The physiotherapist will help you to walk until you can do it by yourself. Phase: 5 Discharge ? When the Doctor says you are ready to go home, whether

15、on day five or later, your care providers will follow the Discharge Planning Checklist and you will be able to go home. Key Milestone (steps) Pre-adm Clin. Admit Pre- Op Post- Op Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Date 1. Placed on pathway 2. Assessed by Ortho Team 3. Blood tests, X-rays etc

16、will be taken 4. IV fluids commenced 5. Prepared for surgery 6. Transferred to surgery 7. Post-operation vital signs 8. Not feeling sick and pain level ok 9. Awake and know where you are 10. Wound ooze minimal 11. Can pass urine after operation 12. Drains removed 13. Compression device removed 14. I

17、V Cannula removed 15. Drinking / eating normally 16. Reviewed by Orthopaedic team 17. Can walk with 2 sticks safely 18. Ready to go home 19. Carer available on going home. 20. Discharge check list completed ? The State of Queensland (Queensland Health) 2022 Page 5 of 25 B I N D I N G M A R G I N D O

18、 N O T W R I T E Total Knee Arthroplasty Clinical Pathway K n e e A r t h r o p l a s t y P a t h w a y V 3.2 180707 M R C O 002 Page 6 of 25 Total Knee Arthroplasty Clinical Pathway B I N D I N G M A R G I N D O N O T W R I T E ? The State of Queensland (Queensland Health) 2022 Page 7 of 25 B I N D I N G M A R G I N D O N O T W R I T E Total Knee Arthroplasty Clinical Pathway K n e e A r t h r o p l a s t y P a t h w a y V 3.2 180707 M R C O 001 Page 8 of 25 Total Knee Arthroplasty Clinical