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KMID : 0614820140200010117
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Journal of Korean Academy of Nursing Administration
2014 Volume.20 No. 1 p.117 ~ p.127
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Development and Long Term Evaluation of a Critical Pathway for the Management of Microvascular Decompression
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Lee Jeong-A
Kim Jung-Sook
Park Kwan
Kong Doo-Sik
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Abstract
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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.
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KEYWORD
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Critical pathway, Microvascular decompression surgery, Quality control, Cost-benefit effectiveness
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