Patients Identity (Sticker)

Clinical Pathway : PNEUMOTHORAX

Date : Allergy: Yes No

Room : Unsure

Expected Length of Stay : Allergy Sticker

Operation Date (if any) :

Please fill with () on the column below Drug Allergy :

DISCHARGE OUTCOMES To be Completed before discharge

Support at home is adequate following discharge

Able to ambulate to optimum level

Demonstrates understanding of post operative care

VARIANCE CODE LIST record any variations as a () on Care Path and document in Integrated Progress Notes

1. Patient 2. Internal System 3. Social/Community

1.1 Vital Signs/Observation 2.1 Unplanned Cancellations 3.1 Delay in Transport
1.2 Consults & Examination 2.2 Delay in Consultations 3.2 Delay in Home Support
1.3 Pain Management 2.3 Delay in Discharge Planning 3.3 Equipment Unavailability
1.4 Treatments 2.4 3.4 Financial issue
1.5 Nutrition and Hydration 3.5
1.6 Elimination
1.7 Risk Assesment & PIVAS
1.8 Mobilization & Physiotherapy
1.9 Hygiene & Skin Integrity
1.10 Individual Needs
1.11 Education & Discharge Needs
1.12

ADDITIONAL (Name, Signature, Designation, Initials) Comorbidity / Risk Factors

No Doctors Name Nurses Name Verificator
(State clearly)
Clinical Pathway Notes : if done according to Clinical Pathway
Pneumothorax -- if not done according to Clinical Pathway
N/A if the application is not according to Clinical Pathway
X if there are error in application of Clinical Pathway
Day 0 1 2
A P N A P N A P N
Date M M S M M S M M S
Assessment - Medical Report - Progress Notes - Progress Notes
- VTE form - Regularly Vital Sign - Regularly Vital Sign
- Phlebitis Form - Specialist visit - Specialist visit
- Patient Education Forms (if any) Forms (if any)
Form - Discharge
- Integrated Progress summary
Notes
- Specialist visit
Forms (if any)
- Surgery and
Anesthesia consent
Consult & - Vital Sign - Vital Sign - Vital Sign
Examination - Anamnesis and - Anamnesis and - Anamnesis and
Physical Exam Physical Exam Physical Exam
- Laboratory Exam - Laboratory Exam - Laboratory Exam
- X-ray or CT- Scan - Control X-rays -
Diet As tolerated As tolerated As tolerated
Activity Bedrest Bedrest Gradual mobilization
Fluids
Pain - Visual Analog Scale - Visual Analog Scale - Visual Analog Scale
Management - Analgesic - Analgesic - Analgesic
Medications - Antibiotics - Antibiotics - Antibiotics
- PPI - PPI - PPI
- NSAID - NSAID - NSAID
- - -
- - -
- - -
- - -
- - -

Procedure Thoracostomy-WSD Chest physiotherapy

(date&time)
Monitoring - Balance/UP - Balance/UP - Balance/UP
- Bowel Movement - Bowel Movement - Bowel Movement
- chest tube prod. - chest tube prod.
- wound dressing - wound dressing
Individual
Needs
Patient
Safety
Patient -
Education -
Discharge
Plan
Variant / Reason : Variant / Reason : Variant / Reason :
Clinical Pathway Notes : if done according to Clinical Pathway
Pneumothorax -- if not done according to Clinical Pathway
N/A if the application is not according to Clinical Pathway
X if there are error in application of Clinical Pathway
Day 3 4 5
A P N A P N A P N
Date M M S M M S M M S
Assessment - Medical Report - Progress Notes
- VTE form - Regularly Vital Sign
- Phlebitis Form - Specialist visit
- Patient Education Forms (if any)
Form
- Integrated Progress
Notes
- Specialist visit
Forms (if any)
Consult & - Vital Sign - Vital Sign - Vital Sign
Examination - Anamnesis and - Anamnesis and - Anamnesis and
Physical Exam Physical Exam Physical Exam
- Laboratory Exam - - Laboratory Exam
- Control X-rays - Control X-rays
Diet As tolerated As tolerated As tolerated
Activity Gradual mobilization Gradual mobilization Gradual mobilization
Fluids
Pain - Visual Analog Scale - Visual Analog Scale - Visual Analog Scale
Management - Analgesic - Analgesic - Analgesic
Medications - Antibiotics - Antibiotics - Antibiotics
- PPI - PPI - PPI
- NSAID - NSAID - NSAID
- - -
- - -
- - -
- - -
- - -

Procedure Chest physiotherapy Chest physiotherapy Chest physiotherapy

(date&time)
Monitoring - Balance/UP - Balance/UP - Balance/UP
- Bowel Movement - Bowel Movement - Bowel Movement
- chest tube prod. - chest tube prod. - chest tube prod.
- wound dressing - wound dressing - wound dressing
Individual
Needs
Patient
Safety
Patient -
Education -
Discharge
Plan
Variant / Reason : Variant / Reason : Variant / Reason :
Clinical Pathway Notes : if done according to Clinical Pathway
Pneumothorax -- if not done according to Clinical Pathway
N/A if the application is not according to Clinical Pathway
X if there are error in application of Clinical Pathway
Day 6 7 8
A P N A P N A P N
Date M M S M M S M M S
Assessment - Medical Report - Progress Notes
- VTE form - Regularly Vital Sign
- Phlebitis Form - Specialist visit
- Patient Education Forms (if any)
Form
- Integrated Progress
Notes
- Specialist visit
Forms (if any)
Consult & - Vital Sign - Vital Sign - Vital Sign
Examination - Anamnesis and - Anamnesis and - Anamnesis and
Physical Exam Physical Exam Physical Exam
- - Laboratory Exam -
- Control X-rays -
Diet As tolerated As tolerated As tolerated
Activity Gradual mobilization Gradual mobilization Gradual mobilization
Fluids
Pain - Visual Analog Scale - Visual Analog Scale - Visual Analog Scale
Management - Analgesic - Analgesic - Analgesic
Medications - Antibiotics - Antibiotics - Antibiotics
- PPI - PPI - PPI
- NSAID - NSAID - NSAID
- - -
- - -
- - -
- - -

Procedure Chest physiotherapy Chest physiotherapy

(date&time)
Monitoring - Balance/UP - Balance/UP - Balance/UP
- Bowel Movement - Bowel Movement - Bowel Movement
- chest tube prod. - chest tube prod. - Pain scale
- wound dressing - wound dressing
Individual
Needs
Patient
Safety
Patient -
Education -
Discharge DISCHARGED
Plan
Variant / Reason : Variant / Reason : Variant / Reason :