Post Tonsillectomy Care Bundle
(Complete all sections)
Patient Name (BLOCK CAPITALS): ________________________________
D.O.B:___________
IP Number: __________
Consultant: ________________
MOI: ____________
Date: ________
Time: ___________
Transferring Nurse: ___________
On arrival to theatre, nurse to check:
Tick if YES
Initials
1a) Patient File Complete?
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Patients MUST be transferred with all post-operative instructions, drug chart and IV prescription chart and vital signs
documented in patient notes by the surgeon and anaesthetist.
1b) Verbal handover from surgical team and anaesthetist regarding post op plan obtained [ ]
______
Do not transfer the patient back to the ward without complete patient and verbal handover.
2a) Is Patient “Post Op Stable” ?
 awake
 protecting their airway (no noisy breathing/pooling of secretions/snoring)
 with adequate analgesia
 not vomiting
 haemodynamically stable (vital signs in normal parameters, no chest in drawing)
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If does not fulfil all criteria above, seek clarification/advice from surgeon and anaesthetist and continue to do vital
signs every 15 minutes until the patient is “Post Op Stable”. Vital signs are Temperature, Pulse, Respiratory Rate
and Oxygen Saturations. Document vitals on the patient chart.
At any point if vital signs are not normal, inform surgical team/anaesthetist
3a) Are there IV fluids running (is it prescribed on chart/is the drip rate correct)?
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3b) Are all the drugs prescribed on the drug chart as per surgical and anaesthetic plan? [ ]
______
Once a patient is “Post Op Stable”
4a) Vital signs every 30 minutes for 4 hours/ are there any complications/pain?
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(Complications are nausea and vomiting, bleeding from nose/mouth, patient frequently clearing secretions in
throat, noisy breathing, tachycardia, pallor, behavioural disturbance, hypoxia – inform MOI/anaesthetist)
4b) Review the drip rate every 30 minutes for 4 hours
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5a) Vital signs every hour for 20 hours/ are there any complications/pain?
5b) Review the drip rate every hour
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6) Vital signs 4 hourly until discharge
7) Does patient meet all discharge criteria
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Discharge Criteria:
Vital signs are stable and within normal limits
Tolerating fluid, advancing to normal diet
No vomiting
Has voided post operatively
Pain controlled by oral analgesia
Information on post-op. care & contact telephone numbers provided to carers