The Application Of Clinical Pathway In Patients Undertaking Medium Thickness Free-Skin Grafting

ObjectivesTo formulate a science form on medium thickness free-skin grafting Clinical Pathway (CP), implement it and to regulate the behavior of clinical staff in the diagnosis and treatment evaluate its effects in standarding the medical care programmes, improving the quality of clinical care, shortening the average hospital stays, reducing hospitalization costs and improving the satisfaction of patients in this research.MethodsThis research was implemented in two coherent stages. In the first stage, based on a retrospection survey in100cases of medium thickness medium thickness free-skin grafting from Department of Plastic Surgery, the First Affiliated Hospital of Zhengzhou University from November,2010to May,2011, by the methods of data statistics and analyzing, exploring evidences and consulting experts, we can formulate the forms of medium thickness medium thickness free-skin grafting CP and calculate the standard length of stay. In the second stage, based on non-randomized case-control study,156patients of medium thickness free-skin grafting were divided into two groups:the78patients hospitalized during August,2011to march,2012were researched as the controlled group which got routine care; the78patients hospitalized during August,2011to march,2012were treated as the experimental group which was explored in medium thickness free-skin grafting CP. The two groups were compared by contrast analysis and variances were also analyzed. During the two stages, different statistic methods are including the general descriptive statistics, χ2test, independent samples and t-test.ResultsIn the first stage, the forms of medium thickness free-skin grafting CP were designed. The CP forms were standardized by "task-time" designation. Care items included examinations, assessment and interventions, drug uses, safety and exercises, diet and nutrition, diagnosis, expected outcomes and variances were all arranged in each period strictly. Clinical staff were asked to mark to verify the item have been accomplished. In the second stage, after medium thickness free-skin grafting CP had been implemented, the research demonstrated that the experimental group’s total and each period length of hospital stay were less than the controlled group (P<0.01); The expenditure in experimental group declined had no statistical significance (P>0.05); It indicated lower anxiety assessment value in experimental group (P<0.05,P<0.01); The experimental group performed far more satisfaction than the controlled group in10items of the questionnaire(P<0.05, P<0.01), excepted in3items which were "the clinical staff operated accomplished","the clinical staff stayed in the ward and asked your requirements actively" and "the clinical staff protected your privacy in treatments" have no difference(P>0.05); The scores of mastering health care knowledge in disease in experimental group was higher than that of in control group (P<0.05,P<0.01).Conclusions1. In contemporary medical system in China, exploring CP is helful and practical to the clinical specialty. This project outlined some certern references to the promotion of CP in clinical practice in the future.2. With the establishment and implementation of the medium thickness free-skin grafting CP, the patients’satisfaction of clinical staff would be improved, the rate of mastering health care knowledge would be higher, the patients would get lower anxiety and spend less time in the hospital, as a result the clinical treatment quality would be improved.