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Development and Long Term Evaluation of a Critical Pathway for the Management of Microvascular Decompression

간호행정학회지 2014년 20권 1호 p.117 ~ 127
KMID : 0614820140200010117
이정아 ( Lee Jeong-A ) - 삼성서울병원 간호부

김정숙 ( Kim Jung-Sook ) - 한국성서대학교 간호학과
박관 ( Park Kwan ) - 성균관대학교 의과대학 삼성서울병원 신경외과학교실
공두식 ( Kong Doo-Sik ) - 성균관대학교 의과대학 삼성서울병원 신경외과학교실

Abstract

Purpose: In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed.

Methods: This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group.

Results: The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002).

Conclusion: The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP.
KeyWords

Critical pathway, Microvascular decompression surgery, Quality control, Cost-benefit effectiveness
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학술진흥재단(KCI) KoreaMed