Pathway Caes

The State of Queensland (Queensland Health) 2012 Contact CIM@health.qld.gov.
au
(Affix identification label here) URN:
Caesarean Birth Clinical Pathway

Facility:
.........................................................................................................
Family name: Given name(s): Address: Date of birth: Sex: M F I
Clinical pathways never replace clinical judgement. Care outlined in this clinical pathway must be altered if it is not clinically appropriate for the individual client. Consultant:

Admission date:
Time:
SW231d
SW231
Mat. No.: 10253035
v7.00 - 06/2012
o s e t s o rin p r p u p nd l a a n d o i a t o a nl r t w s u do l l i r r o Fo t f o N
Documentation instructions:

DRG O01C Caesarean Delivery without Complicating Diagnosis (ALOS 3.98) DRG O01B Caesarean Delivery with Severe Complicating Diagnosis (ALOS 5.48) DRG O01A Caesarean Delivery with Multiple Complicating Diagnosis At least one severe (ALOS 9.33) AN-DRG V 5 Hospital Benchmarking Funding Model 2004/05
DO NOT WRITE IN THIS BINDING MARGIN
Initials - Indicates action / care has been ordered / administered. N/A - Indicates preceding care / order is not applicable. Crossing out - Indicates that there is a change in the care outlined. V - Indicates a variation from the pathway on that day, in that section. When applicable flag it in the Variance column, then document in the free text area as instructed. If this variance occurs more than once daily, document the additional times of the variance in the variance free text area and in the patients progress notes as applicable. Key Midwife / Nursing Medical / GP Physiotherapist Pharmacy Allied Health Symbols guide care to a primary professional stream, it is a visual guide only and its direction is not intended to be absolute. A Caesarean Birth Clinical Pathway Ongoing Care (Additional Page) (SW231a) is available for extended treatment. A Caesarean Birth Clinical Pathway Clinical Events / Variances (Additional Page) (SW231b) is available if more space is required for clinical events and variances. Every person documenting in this clinical pathway must supply a sample of their initials and signature below. Ensure Expected Outcomes - Mothers copy (last page) is removed from the Caesarean Birth Clinical Pathway and given to the mother.
y l n
Signature log
Initials
CAESAREAN BIRTH CLINICAL PATHWAY
Signature
Print name
Role
Page 1 of 15
Every person documenting in this clinical pathway must supply a sample of their initials in the signature log
Education plan
Key
Category Understands immediate postpartum changes
Midwife / Nursing
Medical / GP Physiotherapist
Yes No
Pharmacy
Allied Health
Initial Date
Interpreter required Discuss and explain:
Cleaning, dressing and caring for wound Abdominal / pelvic floor exercises Breast changes
Postnatal follow up
Physiotherapist Infant feeding
Bleeding up to 6 weeks after birth Returning to normal activities Emotional states EPDS noted: ..........................................................................................................................................
....
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Midwife / Medical Officer follow up in ..................days / weeks
Copy of Pregnancy Health Record given to mother
Mother to make own appointment with local doctor / General Practitioner (GP) / Treating Specialist / Physician, a hospital birth discharge summary will be sent to him / her Post natal contact phone call up to 5 days post discharge Date: ........................... and time: ........................... arranged (if applicable)
Discuss last pap smear and when to have next one
Discuss and explain Deep Venous Thrombosis (DVT) signs and symptoms
Discuss 13 Health (13 432 584) and 24 Hour help line 1800 686 268 numbers and community supports Child Health Information - Your guide to the first 12 months booklet identified and discussed
Reinforce: Seeking medical assistance immediately you experience fever, pain or increased bleeding Discuss the importance of abdominal / pelvic floor health and ask if mother understands and has practiced her abdominal / pelvic floor exercises Mother can demonstrate: Correct attachment breast feeding
Correct detachment for breast feeding Correct positioning for infant feeding Hand expressing
Discuss breast and nipple care
Discuss safe storage of breast milk
Discuss lactation and / or suppression (if applicable)
When formula feeding, is mother able to perform decontamination of bottles, formula preparation and understands transportation and storage techniques Discuss use of simple pain relief for pain management including after birth pains Discuss contraception use (method of choice) Discuss measures to reduce SIDS / SUDI Mother can demonstrate safe sleeping techniques as wrapping, positioning and settling Discuss co-sleeping surfaces, such as not sharing beds and lounges, plus smoke free environments Discuss healthy eating plan and recommend daily intake of water and fibre Discuss infant restraint for vehicle Yes Yes Signature: No No
Pain management Contraception Safe sleeping Same sleeping surfaces Dietary advice Safe car travel
The above education plan on self care, infants and siblings has been discussed with me I have received the Centrelink and Birth registration forms Mother's name (please print):
Page 2 of 15
Discharge plan
Discharge medications arranged Mothers own medications returned Anti D given MMR given Discuss Pertussis immunisation for parents and grandparents Discuss GTT at 6 weeks postnatal (if applicable) Referrals Medical Officer Specialist / Treating Physician Child Health services Lactation consultant Physiotherapist
Initial
Date
Maternity Home Care Services / post natal contact service Continence Advisory Service Allied Health Professional (see notes) Indigenous Healthcare Worker Wound Care Consultant Hospital discharge summary for self and baby given to mother Faxed / sent to GP / Child Health Antenatal screening / family care assessment form completed Transfer to other hospital Time: Facility name: Further notes (including Criteria Led Discharge as per hospital protocol):
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Other (please specify): ..........................................................................................................................................................................................................................
Discharge Clinician
Date:
Time:
Designation:
Signature:
Page 3 of 15

Expected outcomes - CHART copy
Phase 1 Antenatal period Phase 2: Pre- and Post-operation After discussion with your doctor you will be able to state an understanding of the usual pre- and post-operative care routines, the surgery and its effects on you and the baby. After the birth Baby will be placed skin to skin with you as soon as you are able to respond to baby. During this time, baby will be offered its first feed. Management of your pain ensures that your level of discomfort is in a range acceptable to you. Phase 3: Day 1 Post-operative You will be able to explain the outcome of your babys birth. Your Midwife will care for you and check on you and your babys progress. Your midwife will assist you with feeding and caring for your baby. You can expect some vaginal bleeding usually up to about 2 weeks after the birth. In many cases you will be able to go home in 2 days after surgery if appropriate and follow-up arrangements are available. Phase 4: Discharge Once your midwife has gone through your discharge information, and your baby has been reviewed and discharged by a Qualified Healthcare Professional, you may go home. Phase 5: After discharge You will be contacted via phone or a home visit up to 5 days post discharge. A midwife may visit you in your home to provide ongoing support. You will be offered referral to community health groups for ongoing support, i.e. Child Health, Australian Breastfeeding Association. You will require ongoing care from your local doctor / General Practitioner (GP) / Specialist / Treating Physician. When you visit your doctor please take along you and your babys hospital discharge summary and babys Personal Health Record.
1P ost
2P ost
3P ost
mC
ena
Pre -ad
Day
hou
Day
Day
Day
1. 2. 3. 4. 5. 6. 7. 8. 9.
Placed on pathway
Your care will follow the clinical pathway
If needed you will have blood tests taken
You will be seen by the Obstetric doctors You will be admitted to hospital
You will attend pre-admission clinic for an elective LSCS
You will be prepared for theatre / if elective LSCS you will be expected to fast at least 8 hours prior to surgery You will be transferred to the Operating Theatre (OT) Observations taken as needed Anaesthetic will be administered You will be prescribed and offered regular pain relief, after your operation There will only be a little or nil wound ooze on your dressing You will be eating and drinking normally Your drip and catheter will be removed You may by seen by your doctor daily
10. 11. 12. 13. 14. 15. 16. 17.
The midwife will assist you in learning how to feed and care for your baby
Ready for discharge. You may be given a copy of the hospital birth summary / perinatal data report to give to your local doctor. Alternately, this will be posted to your local doctor. Page 4 of 15
Day
16
Ant
4P ost
of O
Key milestones
c rs P ost -OP -OP -OP -OP lini tal P
y l n
-OP
Admission day
Instructions: Initials - care attended to, Rule out - not applicable, V - variance (record and sign all variances on sheet provided or progress notes)
Key
Category Reviews
Midwife / Nursing
Pharmacy
Allied Health
Date: ............. / ............. / ........................ Surgical obstetric review and admitted by medical staff Mothers status unchanged from pre admission
Venous thrombus embolism (VTE) risk assessment reviewed and treatment commenced as ordered Consent - completed, questions answered and consent form signed ID bands - secured Booked for Operating Room Suite - time: ....................................... As clinically indicated Investigations All results available and have been reviewed by medical staff Pre-operative skin check Medications / pain management Skin integrity of operative site intact Medications reviewed and ward medication chart complete Prophylaxis antibiotics discussed and documented Medications given as ordered Observations / treatments Orientated to ward and admission process explained Midwifery admission complete Operation site prepared Baseline observations - documented and within normal limits Pre-operative checklist complete Falls risk identified and recorded Pressure injury / Waterlow score assessed and recorded Fasted from - diet: ..................................... hrs Showered and prepared for theatre Anti-embolic therapies available Stockings correctly applied Nutrition fluids: .................................. hrs Hygiene / elimination Activity / mobility Mother education and discharge Expected outcomes Confirmation that Expected Outcomes (mothers pathway) was given and that all procedures were explained and video (if applicable) shown in pre-admission clinic Mother states: A - Achieved V - Variance 2.1 Mother able to state the usual pre-and post-operative care routines, the surgery and its effects and their concerns have been adequately addressed Further notes:
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Initial
Additional tests: ................................................................................................................................................................................
Page 5 of 15
All perioperative documentation to be inserted here including ORMIS documentation if applicable
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Page 6 of 15
Post-op day of surgery

Key
Reviews
Midwife / Nursing
Date:
Pharmacy
Allied Health
Initial
06 hrs
toDate: 1 2 3 4 (NICE guidelines 2004)
Urgency of LSCS Category:
Gravida Parity Gestation 39 weeks Medical decision to birth, within time appropriate to urgency category Perinatal data report commenced Nil postnatal risks identified
1. Immediate threat to the life of a woman or foetus 2. Maternal or fetal compromise but not immediately life threatening 3. Needing early delivery but no maternal or fetal compromise 4. At a time to suit the woman and the caesarean section team
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Time
Time of birth: ............................................ Transfer to ward: ............................................

Medications given as ordered Stockings insitu Spinal Thromboembolic prophylaxis administered (if ordered) Pain is managed - pain score 3 Epidural Analgesia effective
Medications
Pain management
PCA
Infusion
IMI
Oral
Spinal morphine analgesia administered
Observations / Treatments
Observations of vital signs recorded as per hospital/statewide protocol Spinal Epidural GBS Diabetes LBW / SGA Other (specify: .............................................................................................................. ) Nausea and vomiting controlled Estimated blood loss amount: ..................................... mL
Skin-to-skin when mother physically able Lochia - bright red, 1 pad / hour Fluid balance chart maintained
Nil / small amount of wound ooze, dressing intact IV cannula - patent, no signs of inflammation
Nutrition
Tolerating fluids / diet
Hygiene
Hygiene needs attended - post-op sponge and pressure area care attended, nil reddened areas noted IDC insitu - draining straw coloured urine, output > 30mls hour until mobile Dressing intact / wound ooze minimal
Elimination
Wound and dressings Mobility
Discuss and demonstrate deep breathing and leg exercises
Pressure injury / Waterlow score assessed and recorded

Falls risk identified and recorded Education Communication assistance required and utilised? Yes No State type: ........................................................................................................................................................................... Education plan updated Discharge Expected outcomes Discharge plan updated Ask mother about the following 2.1 Mother has all her concerns addressed such as her personal requests, breast or formula feeding and her babys cares 2.2 Pain / discomfort at an acceptable level to the mother 2.3 Performing deep breathing and leg exercises to prevent complications Initial Time V
Page 7 of 15
Post partum LSCS

Key
Review and physical assessment
Midwife / Nursing
Date:
Pharmacy
Allied Health
Initial Time
624 hrs
toDate:
Proceeding according to clinical pathway Fundus (monitor / observe firm and central) Bleeding within expected limits Post-op observations reviewed
Physiotherapist Documents
Enter shift that will occur predominately within the next 8 hours
Medication Stocking insitu (if applicable)
Pain management Observations
IVT
Breasts / nipples Infant feeding
Wound Lochia
Elimination
Legs
Positive blood group - anti D not required Wound intact and clean Nil other complaints Rubella immune - vaccination not required
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V
Bladder / bowel function, posture, ergonomics, back care and pelvic floor rehabilitation discussed Babys Personal Health Record commenced Perinatal data report commenced
Time
Thromboembolic prophylaxis administered (if ordered)
Minimal discomfort, managed with prescribed / simple analgesia
Observations of vital signs recorded as per hospital/statewide protocol Spinal Epidural GBS Diabetes LBW / SGA Other (specify: .............................................................................................................. ) IV Therapy patent, running to time, no signs of inflammation Breasts soft, nipples intact, hand expressing demonstrated Mother assessed as awake and lucid, call bell within reach Breast feeding - offered assistance Demonstrate feed chart recording Bright red, 1 pad / hour Formula feeding - offered assistance
Dressing removed (If using COMFEEL leave insitu for 7 days) Catheter insitu, draining straw coloured urine, > 30ml / hr IDC removed as per hospital protocol Has voided post IDC removal Has passed flatus
Full sensation and movement, nil calf tenderness Tolerating fluids / diet Showered with assistance Mobilising with assistance
Nutrition Hygiene Mobility
Pressure injury / Waterlow score assessed

Mother / partner / baby falls risk identified and recorded Emotional state Patient education Emotional needs identified including labour and birthing concerns Communication assistance required and utilised? State type: ................................................................................................................................ Education plan updated Discharge Expected outcomes Discharge plan updated Ask mother about the following 3.1 Mother has all her concerns addressed and her pain / discomfort at an acceptable level to care for herself and her baby. Initial Time V
Page 8 of 15
Post partum LSCS

Key
Review and physical assessment
Midwife / Nursing
Date:
Pharmacy
Allied Health
Initial
2448 hrs
toDate:
Proceeding according to clinical pathway Fundus (monitor / observe) Bleeding within expected limits Wound intact and clean Nil other complaints
Returning to normal bowel movements Nil postnatal risks identified / alerts Physiotherapist
y l n
Time Time
Bladder / bowel function, posture, ergonomics, back care and pelvic floor rehabilitation discussed Thromboembolic prophylaxis administered (if ordered) Stocking insitu (if applicable)
Medication
Minimal discomfort, managed with prescribed /simple analgesia
Observations of vital signs recorded as per hospital/statewide protocol Spinal Epidural GBS Diabetes LBW / SGA Other (specify: .............................................................................................................. ) Breasts soft, nipples intact, hand expressing demonstrated Mother assessed as awake and lucid, call bell within reach Breast feeding - offered assistance
Breasts / nipples
Infant feeding
Formula feeding - offered assistance and able to make formula Wound edges well approximated, nil / minimal wound ooze Dark red - Pink, 1 pad / 2 hours Bowels opened Nil dysuria, no urinary incontinence or voiding difficulties Nil calf tenderness
Wound Lochia
Elimination Legs
Tolerating fluids / diet
IV removed, no signs of inflammation Showered independently Mobilising independently
Mother / partner / baby falls risk identified and recorded Education plan updated Discharge plan updated and completed Ask mother about the following
Emotional state Education Early discharge Expected outcomes
Emotional needs identified including labour and birthing concerns
Initial
Time
3.1 Mother has all her concerns addressed and her pain / discomfort at an acceptable level to care for herself and her baby.
Further notes:
Page 9 of 15
Post partum LSCS

Key
Midwife / Nursing
Date:
Pharmacy
Allied Health
Initial Time
4872 hrs
Review
toDate:
Hospital care
Home care
Physiotherapist Medication
Stocking insitu (if applicable)
Wound Lochia
Elimination Legs
Emotional state Education Expected outcomes Further notes: Discharge
Fundus observed to be in normal position Nil complaints Discharged Nil postnatal risks identified / alerts
Proceeding according to clinical pathway
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V V
Bladder / bowel function, posture, ergonomics, back care and pelvic floor rehabilitation discussed Thromboembolic prophylaxis administered (if ordered) Minimal discomfort, nil pain relief required
Time
Discomfort managed with prescribed analgesia BD observations within normal parameters Breasts firming and filling, nipples intact
Mother assessed as awake and lucid, call bell within reach Breast feeding - requires minimal supervision
Formula feeding - understands increasing formula volumes required by infant Wound is clean and dry Dark red - pink, 1 pad / 2 hours Bowels opened
Nil dysuria, no urinary incontinence or voiding difficulties Nil calf tenderness Tolerating full diet
Showered independently Mobilising independently
Mother / partner / baby falls risk identified and recorded Education plan updated and completed Ask mother about the following
Emotional needs identified including labour and birthing concerns Discharge plan updated and completed
Initial
Time
3.1 Mother has all her concerns addressed to care for herself and her baby.
Page 10 of 15
Post partum LSCS

Key
Midwife / Nursing
Date:
Pharmacy
Allied Health
Initial
7296 hrs
Review
toDate:
Hospital care
Home care
Fundus observed to be in normal position Nil complaints Discharged Nil postnatal risks identified / alerts Physiotherapist
Proceeding according to clinical pathway
y l n
Time Time
Bladder / bowel function, posture, ergonomics, back care and pelvic floor rehabilitation discussed Thromboembolic prophylaxis administered (if ordered) Stocking insitu (if applicable) Minimal discomfort, nil pain relief required
Medication
Discomfort managed with prescribed analgesia BD observations within normal parameters Breasts firming and filling, nipples intact
Mother assessed as awake and lucid, call bell within reach Breast feeding - requires minimal supervision
Formula feeding - understands increasing formula volumes required by infant Wound is clean and dry Dark red - pink, 1 pad / 2 hours Bowels opened
Wound Lochia
Elimination Legs
Nil dysuria, no urinary incontinence or voiding difficulties Nil calf tenderness Tolerating full diet
Showered independently Mobilising independently
Mother / partner / baby falls risk identified and recorded Education plan updated and completed Ask mother about the following
Emotional state Education Expected outcomes Discharge
Emotional needs identified including labour and birthing concerns Discharge plan updated and completed
Initial
Time
3.1 Mother has all her concerns addressed to care for herself and her baby.
Further notes:
Page 11 of 15
Caesarean Caesarean Birth Birth Clinical Pathway Clinical Pathway Clinical Events / Variances
Clinical events / variances
Date Time Variance code
Expand on variances to clinical pathway for clinical relevance, clinical history, consultations and data collection. Document as Variance / Action / Outcome. (Include name, signature, date and staff category with all entries)
Initials
y l n
B :
Pathway
B:09 Self care difficulties / delay B:11 Timely access to services B:13 Clinical judgement required B:00 Other
D: Post Operative Complications D:06 Post op UTI D:18 Not mobilised - pain / nausea / dizziness D:23 Wound complications D:00 Other
M:
Maternity Related
M: 01 PV loss more than 1 pad per hour M:03 Engorged breast, nipples grazed / cracked M:11 Emergency Caesarean M:00 Other
F: Risk Factors / Social Factors F:01 Alcohol F:02 Allergies and alerts F:03 Lives alone F:06 Smoking F:00 Other
Page 12 of 15
Birth Attendees Print names:

Birth accoucher: Midwife: Witness: Medical officer: Other: Other:
Designation:
URN: Family name: Given name(s): Address: Date of birth:
(Affix identification label here)
Sex:
Birth Summary
Labour: Mode of birth: Presentation: Induction indication/ method: Liquor: Length of labour: Onset of labour Cervix fully dilated Baby born
Spontaneous Augmented Induced
Membranes ruptured:
SROM Date/Time:
ARM Total:
/
Date
Time
Duration 1st stage: 2nd stage: 3rd stage: Total:
Clear Meconium
y l n
hrs
mins
Placenta delivered
Pain relief:
Nil N2O and O2 Narcotic Epidural Sterile water Spinal GA Non-pharmalogical (specify):
Active pushing:
Time of onset:
Duration:
Maternal position at birth:
Third Stage
Birth mode:
Modified active management Active management Manual removal Physiological
Cord blood collected?
Yes
No
Placenta:
Appears complete Incomplete
Blood loss: Oxytocic:
Measured:
Estimated:
Total: mL
Route
mL
mL
Comments:
Time
Dose
.................................................................................. .................... ........................... ...........................
Membranes: Appears complete?

Ragged
Yes
No
.................................................................................. .................... ........................... ...........................
Cord:
pH: BE:
Vessels: Venous: Venous:
.................................................................................. .................... ........................... ........................... .................................................................................. .................... ........................... ........................... .................................................................................. .................... ........................... ...........................
Arterial: Arterial:
Perineal Assessment
Intact 1 tear Episiotomy Type:
2 tear
3 tear
4 tear
Indication:
Repair required?
Yes
NoComments:
Newborn summary
Babys URN: ID checked: ID attached: Date and time of birth: Born: Apgar score: Morphologically normal: Comments:
Signature:
Sex: Yes Yes

/ /
Male
Female
Indeterminate
No No
:
Measurements:
Head Weight: Length: circumference:

g
No No
cm
cm
Konakion given: Macerated Hep B given: Skin to skin contact for at least one hour: Fed:
Yes Yes Yes
Alive
1 min:
Stillborn
5 mins:
No
N/A
Yes
No
If no, duration: Yes, breast No Yes, artificial N/A
o s e t s o rin p r p u p nd l a aleft blank This page is intentionally n d o i a t o a nl r t w s u do l l i r r o Fo t f o N
y l n

Expected outcomes - MOTHERS copy
c rs P ost -OP -OP -OP 1P ost 2P ost mC of O ena Pre -ad Day hou
Phase 1 Antenatal period Phase 2: Pre- and Post-operation After discussion with your doctor you will be able to state an understanding of the usual pre- and post-operative care routines, the surgery and its effects on you and the baby. After the birth Baby will be placed skin to skin with you as soon as you are able to respond to baby. During this time, baby will be offered its first feed. Management of your pain ensures that your level of discomfort is in a range acceptable to you. Phase 3: Day 1 Post-operative You will be able to explain the outcome of your babys birth. Your Midwife will care for you and check on you and your babys progress. Your midwife will assist you with feeding and caring for your baby. You can expect some vaginal bleeding usually up to about 2 weeks after the birth. In many cases you will be able to go home in 2 days after surgery if appropriate and follow-up arrangements are available. Phase 4: Discharge Once your midwife has gone through your discharge information, and your baby has been reviewed and discharged by a Qualified Healthcare Professional, you may go home. Phase 5: After discharge You will be contacted via phone or a home visit up to 5 days post discharge. A midwife may visit you in your home to provide ongoing support. You will be offered referral to community health groups for ongoing support, i.e. Child Health, Australian Breastfeeding Association. You will require ongoing care from your local doctor / General Practitioner (GP) / Specialist / Treating Physician. When you visit your doctor please take along you and your babys hospital discharge summary and babys Personal Health Record.
y l n
-OP
3P ost
Day
Day
Day
1. 2. 3. 4. 5. 6. 7. 8. 9.
Placed on pathway
Your care will follow the clinical pathway
If needed you will have blood tests taken
You will be seen by the Obstetric doctors You will be admitted to hospital
You will attend pre-admission clinic for an elective LSCS
You will be prepared for theatre / if elective LSCS you will be expected to fast at least 8 hours prior to surgery You will be transferred to the Operating Theatre (OT) Observations taken as needed Anaesthetic will be administered You will be prescribed and offered regular pain relief, after your operation There will only be a little or nil wound ooze on your dressing You will be eating and drinking normally Your drip and catheter will be removed You may by seen by your doctor daily
10. 11. 12. 13. 14. 15. 16. 17.
The midwife will assist you in learning how to feed and care for your baby
Ready for discharge. You may be given a copy of the hospital birth summary / perinatal data report to give to your local doctor. Alternately, this will be posted to your local doctor. Page 15 of 15
Day
16
Ant
4P ost
Key milestones
tal
-OP
lini

Pathway Caes

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Pathway Caes

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The State of Queensland (Queensland Health) 2012 Contact CIM@health.qld.gov.

(Affix identification label here) URN:

Caesarean Birth Clinical Pathway

Family name: Given name(s): Address: Date of birth: Sex: M F I

Mat. No.: 10253035

DO NOT WRITE IN THIS BINDING MARGIN

CAESAREAN BIRTH CLINICAL PATHWAY

(Affix identification label here) URN:

Caesarean Birth Clinical Pathway

Family name: Given name(s): Address: Date of birth: Sex: M F I

Interpreter required Discuss and explain:

Physiotherapist Infant feeding

Midwife / Medical Officer follow up in ..................days / weeks

Copy of Pregnancy Health Record given to mother

Discuss last pap smear and when to have next one

Discuss breast and nipple care

Discuss safe storage of breast milk

Discuss lactation and / or suppression (if applicable)

(Affix identification label here) URN:

Caesarean Birth Clinical Pathway

Family name: Given name(s): Address: Date of birth: Sex: M F I

DO NOT WRITE IN THIS BINDING MARGIN

Other (please specify): ..........................................................................................................................................................................................................................

(Affix identification label here) URN:

Caesarean Birth Clinical Pathway

Family name: Given name(s): Address: Date of birth: Sex: M F I

Your care will follow the clinical pathway

If needed you will have blood tests taken

You will attend pre-admission clinic for an elective LSCS

10. 11. 12. 13. 14. 15. 16. 17.

(Affix identification label here) URN:

Caesarean Birth Clinical Pathway

Family name: Given name(s): Address: Date of birth: Sex: M F I

DO NOT WRITE IN THIS BINDING MARGIN

Additional tests: ................................................................................................................................................................................

(Affix identification label here) URN:

Caesarean Birth Clinical Pathway

Family name: Given name(s): Address: Date of birth: Sex: M F I

(Affix identification label here) URN:

Caesarean Birth Clinical Pathway

Family name: Given name(s): Address: Date of birth: Sex: M F I

Post-op day of surgery

toDate: 1 2 3 4 (NICE guidelines 2004)

Urgency of LSCS Category:

DO NOT WRITE IN THIS BINDING MARGIN

Time of birth: ............................................ Transfer to ward: ............................................

Spinal morphine analgesia administered

Tolerating fluids / diet

Wound and dressings Mobility

Discuss and demonstrate deep breathing and leg exercises

Pressure injury / Waterlow score assessed and recorded

(Affix identification label here) URN:

Caesarean Birth Clinical Pathway

Family name: Given name(s): Address: Date of birth: Sex: M F I

Post partum LSCS

Pain management Observations

Breasts / nipples Infant feeding

DO NOT WRITE IN THIS BINDING MARGIN

Thromboembolic prophylaxis administered (if ordered)

Minimal discomfort, managed with prescribed / simple analgesia

Nutrition Hygiene Mobility

Pressure injury / Waterlow score assessed

(Affix identification label here) URN:

Caesarean Birth Clinical Pathway