A nurse is a member of an interdisciplinary team that uses critical pathways.According to the critical pathway,on day 2 of the hospital stay,the patient should be sitting in the chair.It is day 3,and the patient cannot sit in the chair.What should the nurse do?

A) Focus charting,using the DAR format.
B) Add this observation to the problem list.
C) Document the variance in the patient's record.
D) Report a positive variance in the next interdisciplinary team meeting.

Question

Jason Taylor · Accepted Answer

Final Answer : C, Explanation :  A variance is the situation when the activities on the critical pathway are not completed as predicted or the patient does not meet expected outcomes.An example of a variance is when a patient develops pulmonary complications after surgery,and oxygen therapy and monitoring with pulse oximetry are needed.A positive variance is a situation when a patient progresses more rapidly than expected (e.g. ,use of a Foley catheter may be discontinued a day early).When a nurse is using the problem-oriented medical record,after analyzing data,health care team members identify problems and make a single problem list.A type of narrative format charting is focus charting.It involves the use of DAR notes,which include data (both subjective and objective),action (or nursing intervention),and response of the patient (i.e. ,evaluation of effectiveness).

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