Impact of a Clinical Pathway on the Postoperative Care of Children Undergoing Surgical Closure of Atrial Septal Defects

Michelle DeSomma, Abhay Divekar, Aubrey C. Galloway, Stephen B. Colvin, Michael Artman, Marcelo Auslender

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

The purpose of this study was to impact of a clinical pathway on the postoperative management of children undergoing surgical closure of atrial septal defects (ASDs). Three groups of children were studied: group 1 (14 patients), before introduction of an intensive care team, minimally invasive surgery, and the clinical pathway; group 2 (17 patients), after the introduction of the intensive care team and minimally invasive surgical techniques but before the pathway; and group 3 (30 patients), after implementation of the clinical pathway. Average hospital length of stay fell from 118.52 ± 19.83 hours (4.9 ± 0.83 days) in group 1 to 95.92 ± 66.48 hours (3.99 ± 2.77 days) in group 2 and declined further to 54.29 ± 20.17 hours (2.26 ± 0.84 days) in group 3 (p < .05). There were statistically significant decreases in laboratory resource utilization (p < .05). The addition of a dedicated intensive care team and utilization of minimally invasive surgical techniques reduced mean length of stay (by 20%) and resource utilization (by 50%). However, only the implementation of the pathway provided the consistency necessary for maximal quality management, cost saving, and reduction in length of stay (additional 44% reduction in mean length of stay and 40% reduction in resource utilization). These results show the incremental advantage of implementing a defined clinical pathway for postoperative management of children with atrial septal defects.

Original languageEnglish (US)
Pages (from-to)243-248
Number of pages6
JournalApplied Nursing Research
Volume15
Issue number4
DOIs
StatePublished - 2002
Externally publishedYes

ASJC Scopus subject areas

  • Nursing(all)

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