Example of ambulation plan
PATIENT DETAILS | |||||
Patient name: | |||||
Address |
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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: | |||||||
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COVID-19 SWAB | |
Patient COVID-19 Swab taken |
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Accompanying Parent COVID-19 Swab taken: |
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Any child protection concerns? |
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Details: |
Access to telephone? |
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Telephone number: |
Can provide transport to return? |
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IV Access: |
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Safety netting advice sheet given: |
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Plan (if positive results/investigation): |