Page 21 - HPB Handbook - May 30 2022 (Flipbook) v2
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Whipple Multidisciplinary Clinical Pathway
Pre-Admit OR Day POD#1 POD#2 POD#3 POD#4- 6 D/C Day
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Assess- Anaesthesia PACU admission OT and PT, if CCAC final
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SD
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CU
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ments Nursing U Fall risk on needed
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Pharm meds arrival to unit CCAC, if needed
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Education Post-op course Orientation Reinforce Reinforce activity Introduce oral Wound care
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SDU 1-2 nights Use of pain meds vity goals Dietary recommend-
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Pain management DB&C DB&C DB&C return to ations
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Alcohol & Smoking Postop mobility Gum chewing work plans Wound care
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cessation from PCA/Epi Return to work plans
Dietician will see post- PO analgesia D/C scripts
op Confirm GP
Observa- Invasive D/C invasive D/C glucose, if D/C Foley
Weigh
Weigh
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tion Ins/outs D/C staples POD10
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Weigh Assess incision present (POD14 if diabetic)
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Drain outputs
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O2 titrate
Glucose qid Glucose qid
Pre-Admit OR Day POD#1 POD#2 POD#3 POD#4-6 D/C Day
ed
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Pain Anaesthesia consult APS APS Transition from D/C epidural
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Manage- epidural to PO Progress to PO pain Add bowel regimen Review plan
ment meds meds Bowel regimen
Nutrition NPO OR day Ice chips Remove NG diet diet DAT
Sips to DAT ~POD1 diet Saline lock IV
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Ch
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Activity Post-op mobility Turn q2h chair
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plan DB&C side of bed in AM DB&C
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6-8wks no heavy DB&C
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B&C
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lifting Chair 2+x > 1 hr
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&C
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Assess pre-op Ambulate 2+ x m x 3-5x Independent
mobility status ambulate- 2x 70m,
Inform ward if high 3-5x
risk for falls
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Confirm FU
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D/C LOS 5-7 days sh ~D/C Reassess ~D/C Reassess ~ DAY PRE D/C
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Planning Postop FU visit in date date D/C date
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4wks Confirm D/C Consults
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Prep
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2wks no bath Staple environment D/C scripts
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removal Initiate D/C summary
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D/C plans transport Finalize home plans
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Assess home Finalize D/C transport DC Navigator
and return to work plans Extended VTE
needs prophylaxis, if
eligible
