1Nurse Manager, Emergency Medical Center, Jeju National University Hospital, Korea.
2Instructor, College of Nursing, Jeju National University, Korea.
3Assistant Professor, Department of Emergency Medicine, School of Medicine, Jeju National University, Korea.
4Instructor, Department of Emergency Medicine, School of Medicine, Jeju National University, Korea.
Correspondence: Kim, Min Young. Instructor, College of Nursing, Jeju National University 1, Ara 1dong, Jeju city, Jeju Special Self-Governing Province, 690-756, Korea. Tel: 82-64-754-3750, Fax: 82-64-702-2686, musemy2@hanmail.net
• Received: November 12, 2010 • Revised: January 18, 2011 • Accepted: January 18, 2011
The purpose of this study was to demonstrate effects of a critical pathway (CP) for stroke patients seen in emergency rooms (ER).
Methods
The CP developed by the CP committee consisted of 8 criteria: behavior of doctors and nurses, laboratory tests, Image testing, medication, treatment, activity, and nutrition. According to application of CP, a control group (n=17) and experimental group (n=17) were defined. Time was checked by the electronic medical records.
Results
Use of CP for stroke patients in the ER, resulted in a decreased length of stay in ER (t=2.341, p=.026), and time required for image testing (t=2.623, p=.021), and an increased number of patients using rtPA (χ2=4.802, p=.049). Time required for neurology doctor contact, for neurology doctor to see patient in the ER, and for report of blood tests decreased, but there were no statistical significance.
Conclusion
Quick responses are most important in the ER, so CP for these patients is a very effective patient management tool. To reduce delay in stroke diagnosis, continuous education programs for similar symptoms are necessary. CPs for other patients in the ER should be developed, and studies on cost and satisfaction, as well as length of stay, should be done.
1. Choi JY, Jang KS, Choi EY. Development of a critical pathway for the chemotherapy of non-small call lung cancer patients and its effects. J Korean Acad Nurs Adm. 2002;8(1):85-95.
2. Espinosa-Aguilar A, Reyes-Morales H, Huerta-Posada CE, de Leon IL, Lopez-Lopez F, Mejia-Hernandez M, et al. Design and validation of a critical pathway for hospital management of patients with severe traumatic brain injury. J Trauma. 2008;64(5):1327-1341.
3. Hong YM. Developing activity based clinical pathway for patients with total hip replacement. J Korean Acad Nurs Adm. 2002;8(4):669-689.
4. Kim EO. Effects of a standardized critical pathway in gastrectomy patients. 2004;Seoul, Seoul National University. Unpublished doctoral dissertation.
5. Kim GY. Development of a critical pathway for patients with coronary artery bypass graft. J Korean Acad Nurs. 1998;28(1):117-131.
6. Kim JJ, Kim NC, Kim MJ, Kim OS, Kim YS, et al. Medical Surgical Nursing. 2005;Seoul, Hyunmoon publishing.
7. Kim JS. Development of a critical pathway of barbiturate coma therapy in the management for severe brain damage. J Korean Acad Nurs Adm. 2010;16(1):59-72.
8. Kim MJ, Lee JA, Song HS, Kim ES, Yeon MJ, Cho SH. The development of the critical pathway and nursing record for patients received FP chemotherapy. J Korean Acad Adult Nurs. 1999;11(4):845-857.
9. Kim SS, Roh YS. Development of critical pathway for the patients follwing lumbar laminectomy. J Korean Acad Adult Nurs. 1999;11(4):772-784.
12. Latini EE, Foote W. Obtaining consistent quality patient care for the trauma patient by using a Critical Pathway. Crit Care Nurs Q. 1992;15(3):51-55.
14. Lee MK, Doh BN. Effects of critical pathway (CP) on the patients with primary total hip replacement (THR). J Korean Acad Nurs Adm. 2002;8(2):295-308.
15. Lim YJ, Jeong KI, Jeong HY, Sun JJ, Kim YK, Choi JK, et al. Analysis of performance on activities in critical pathway of total hip replacement surgery. J Korean Acad Adult Nurs. 2006;18(5):819-827.
16. Ministry of Health and Welfare. 2001 National Health and Nutrition Survey. 2002;12 30 Retrieved September 30, 2010. National Health and Nutrition Survey. from http://www.mw.go.kr/user.tdf
18. Noh GO, Park KS. Critical pathway development for the hysterectomy patients and its applied effect. J Korean Acad Womens Health Nurs. 2000;6(2):234-257.
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