Clinical Pathway versus Traditional Care Plan method for Caring of Postoperative Children Undergoing Cardio thoracic Surgery

摘要

A clinical pathway is developed to be the ideal plan of care for post operative children undergoing to cardio thoracic surgery. Similarly, some conditions and procedures may have more variable outcomes than others. Although the heterogeneity of children and procedures are important factors in considering the potential impact of clinical pathway. Aim: This study aimed to compare between the traditional nursing care and clinical pathway in planning for caring of postoperative children undergoing cardio thoracic surgery. Methods: A quasi-experimental design was utilized to conduct this study, the study was carried out at Abou-El Resh Talabah Hospital affiliated to Health Insurance and El-Demerdash Hospital affiliated to Ain Shams University Hospital. Sample: Nurses group: A convenience sample consisted of 100 nurses caring for post operative children undergoing cardiothoracic surgery at the previously mentioned study settings. Patients group: A convenience sample of 200 children who were admitted for cardiothoracic surgery in the previously mentioned study settings was recruited for pre and post clinical pathway intervention. Tools of data collection are: Questionnaire format, Observation checklists, Child patient assessment sheet and Clinical pathway map. Results: the percent score of total observation of the care of children patients in the pre-intervention stage study and control groups showed that the scores were very low in both groups. Nonetheless, the score of performance was higher among nurses in the control group (28.8±3.5) compared to those in the study group. Conclusion: In the light of the current study it can be concluded that, nurses’ knowledge about heart diseases in pediatric is generally low and their performance of postoperative care for post operative open heart surgery is unsatisfied. While after the implementation of the clinical pathway the significant improvements in nurses’ knowledge and performance was observed; all the areas were adequately performed by almost all nurses for almost all children in the study group. This is reflected on child’s outcomes as measured by the length of hospital stay, which was significantly shortened in comparison to pre-intervention stay as well as control group stay. Meanwhile, the clinical pathway team members namely, nurses and resident physician acquired good knowledge about the clinical pathway and the satisfaction level improved post implementation. Recommendations: Further studies should be carried out on a large number of nurses for evidence of results and generalization.