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UR Number
Family Name
Total Knee Arthroplasty Clinical Pathway Given Names
Date of Birth Sex M F
Facility: Affix patient label here
Clinical Pathway Orthopaedic
TOTAL KNEE ARTHROPLASTY
DRG I 04Z Knee Replacement Reattachment (ALOS 7.65)
AN-DRG V5 Hospital Benchmarking Funding Model 2004/05
Clinical pathways never replace clinical judgement.
Care outlined in this pathway must be altered if it is not clinically appropriate for the individual patient.
CONSULTANT:-_____________________ ADMISSION DATE: ________TIME:_______
Documentation Key
1. Sign - Indicates action / care has been ordered or administered.
2. N/A - Indicates preceding care / order is not applicable.
E 3. Crossing out - Indicates that there is a change in the care outlined.
T
I 4. V - Indicates a variation from the pathway on that day, in that section. When applicable flag it in the
R
W Variance column, then document in the free text area date / variance code variance / action / outcome.
T
O Key Medical Nursing ♣ Occupational Therapy Pharmacy Physiotherapy
N
O Symbols guide care to a primary profession,
D
– it is a visual guide only and its direction is not intended to be absolute.
N
I
G SIGNATURE LOG
R
A Every person documenting in this clinical pathway MUST supply a sample of
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