https://scholars.lib.ntu.edu.tw/handle/123456789/157140
Title: | The Development and Implementation of the Clinical Pathway: Pediatric Femoral and Inguinal Hernia Repair 小兒腹股溝疝氣修補術臨床路徑的發展及應用 |
Authors: | 李雅玲 林宜蓉 施富金 黃金蓮 LEE, YA-LING LIN, I-JONGSHIH, FU-JIN HUANG, CHIN-LIAN |
Keywords: | 疝氣;臨床路徑;成本效益;醫療品質;護理標準;hernia | Issue Date: | 2000 | Journal Issue: | n.3 | Start page/Pages: | 191-196 | Source: | 慈濟醫學,v.12 | Abstract: | 目的:研究臨床路徑的發展與實施,以及在醫療成本控制、病患住院日數、醫療品質 變異控制、文書記錄時間、及護理標準的影響。材料與方法:本研究以台北某醫學中 心為研究場所,先發展臨床路徑並進行臨床測試之後,進入試用階段,再次經過評估 而成為正式病歷;研究樣本為臨床路徑實施前一年(86.7-87.6,共得230個案)接受 腹股溝疝氣修補的兒童,並請護理人員對於臨床路徑實施給予評值。結果:1.可降低 病童住院日數,實施臨床路徑前平均住院日數為3.22天,實施臨床路徑後平均住院日 數為1.98天,減少1.24天;2.節省醫院的醫療成本花費,共節省平均住院費用35元、 藥費329元、手術費324元;3.降低臨床護理人員的文書工作負荷,記錄時間從原先3. 3分/班降為1.8分/班;4.可監測此路徑的變異狀況以確保病童獲得較高的醫療品質; 5.並建立護理標準使護理工作所依循,研究對象中有92.6%的護理人員對於路徑單取 代護理記錄感到滿意。結論:臨床路徑的實施,的確有助醫院面對全民建保於1995年 施行後的醫療變動,尤其是在成本效益的控制、監測、提供標準化的醫療服務、減少 護理文書記錄時間、及確保病患的醫療品質方面,是值得肯定及推行的政策。 Objective: This research was to study the development and effects of a clinical pathway, in these aspects of medical expenses, length of stay in the hospital, quality of medical care, record-keeping workload, and establishment of nursing standard. Materials and Methods: Consistent with such goals , we established a clinical pathway for Pediatric Femoral and Inguinal Hernia Repaired Surgery. Retrospective and prospective survey were used to study two patient groups: 221 cases were collected from one year duration before clinical pathway adopted, 230 cases from one year duration after clinical pathway adopted. Results: Implementation of the Pediatric Femoral and Inguinal Hernia Repaired Surgery pathway included: 1 . Shortening the hospital stay for children (from 3.22 days to 1.98 days). 2. Decreasing in medical expenses (drug expenses from 812 NT dollars to 483 NT dollars/case). 3. Decreasing record record-keeping workload for nursing staff (from 3.3 min to 1.8 min/shift for each patient). 4. Monitoring the quality of medical care using variance recording. 5. Developing a nursing standard that reaffirms quality patient care. Conclusions: The implementation of this clinical pathway is a positive result of National Health Insurance. It be suggested to apply clinical pathway to other health problem conditions. Besides , the discharge follow up and satisfaction of patients received clinical pathway could be continued to be other good research topics. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/166015 |
Appears in Collections: | 護理學系所 |
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