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VARIANCE RECORDS

  • Much of the record keeping in an ICP is simply checking against the printed proforma to confirm that things have been done
  • If the patient's condition deviates from the progress defined by the pathway, a variance record is created, with a detailed account of the complication and its progress
  • The patient continues on the pathway, but the variance record is kept in parallel
  • When the use of the pathway is later audited, we can see whether a particular variance is documented often enough to justify including it as a regular branch of the pathway in future.

Examples of Variances

  • A patient on an ICP for Fractured Hip develops a chest infection post-operatively. The fact that a variance record is being created is flagged up in the main pathway. The variance record includes the procedures for diagnosis and treatment of the chest infection . Meanwhile the usual nursing procedures for a patient with fractured hip are continued in the main record.
  • A stroke patient has swallowing problems and has to have a minor operation to insert a feeding gastrstomy tube into the stomach. All the usual stroke care continues and is documented on the pathway. However on the day of the insertion procedure, a variance record is created describing in detail what was done at operation.

 

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Copyright ©Nikki Devitt 2002, on behalf of the WAHT Stroke Pathway Group

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Date of last review: 25th April 2002

Date of next review:25th October 2002