Paediatric Pathways

Example of ambulation plan

PATIENT DETAILS
Patient name:
Address
Hospital Number:
Date of Birth:
NHS Number:
Sex:
Phone No: GP:
REQUEST DETAILS
Category Creation Date
Date of referral: Referral Ward/Department:
Requester:
Contact No: Bleep:
Clinical Lead: Priority:
Clinical details
Relevant Results: Creation Date
Date of referral: Current Antibiotic Therapy (dose & frequency):
   
Pending results/dates expected: Allergies:
 
Duration of treatment:
 
Provisional stop date:
 
Previous Antibiotic Therapy
 
COVID-19 SWAB
Patient COVID-19 Swab taken

Accompanying Parent COVID-19 Swab taken:

Any child protection concerns?

Details:
Access to telephone?

Telephone number:
Can provide transport to return?

IV Access:



Safety netting advice sheet given:

Plan (if positive results/investigation):