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

doi:10.1053/apnr.2002.35960

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Impact of a clinical pathway on the postoperative care of children undergoing surgical closure of atrial septal defects

Journal article

Peer reviewed

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 and Marcelo Auslender

Applied nursing research, Vol.15(4), pp.243-248

11/2002

DOI: 10.1053/apnr.2002.35960

PMID: 12444583

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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.

Heart Septal Defects, Atrial - surgery

Cardiac Surgical Procedures - standards

Length of Stay - economics

Humans

Child, Preschool

Infant

Pediatric Nursing

Critical Pathways

Cardiac Surgical Procedures - economics

Postoperative Care - nursing

Outcome and Process Assessment (Health Care)

Adolescent

Critical Care

Child

Details

Title: Subtitle: Impact of a clinical pathway on the postoperative care of children undergoing surgical closure of atrial septal defects
Creators: Michelle DeSomma - NYU Medical Center, New York, NY 10016, USA. MLDRN824@aol.com
Abhay Divekar
Aubrey C Galloway
Stephen B Colvin
Michael Artman
Marcelo Auslender
Resource Type: Journal article
Publication Details: Applied nursing research, Vol.15(4), pp.243-248
DOI: 10.1053/apnr.2002.35960
PMID: 12444583
ISSN: 0897-1897
eISSN: 1532-8201
Language: English
Date published: 11/2002
Academic Unit: Stead Family Department of Pediatrics
Record Identifier: 9984093494702771

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