일 병원의 대장절제술 환자를 위한 표준진료지침의 임상적용 효과와 변이분석

Abstract

Purpose : To investigate the effectiveness and variance of a critical pathway (CP) for laparoscopic colon resection in colon cancer patients, and nurses'satisfaction with the CP. Methods : A CP for laparoscopic colon resection was applied to the CP-group that included 50 patients, who underwent elective colon resection between March and May, 2011. The non-CP group included 51 patients who had the same operation without the CP applied from March to May, 2010. Results : The means of length of hospital stay were 11.7 and 7.3 days (p<.001) and the lengths of postoperative hospital stay were 8.6 and 5.1 days (p<.001) in the non-CP group and CP group, respectively. There was no significant difference between two groups for total healthcare costs, pain score, complications, or emergency room visits within 30 days after discharge. By examining variances of the CP, there were 162 variances and the most frequent cause was patient's condition. Nurses'satisfaction with the use of CP was favorable and the mean score of satisfaction was 3.76 on the 5 point Likert scale. Conclusion : There are clear benefits to use of CP, resulting in standardized and effective patient care. In conclusion, analysis of variance data can assist in evaluating and revising CP for optimal care and reducing variances.