The Effect Of Application Of Clinical Nursing Pathway In Patients With Cervical Cancer Surgery In China

Objective To analyse the current situation of clinical nursing pathways in China by visualization approach.To assess the effective of clinical nursing pathway in patients with cervical cancer by meta analysis.To evaluate the cost effectiveness of clinical nursing pathways in patients with cervical cancer surgery when compared with usual medical care.Methods(1)Analysis of research status on clinical nursing pathway:The Chinese Biomedical Literature Database,China National Knowledge Infrastructure,WANFANG Database,PubMed,EMBASE.com and Web of Science were searched from inception to Jan 2017 to identify clinical nursing pathways.Our study extracted the information of author by BICOMS 2 software,at the same time,the figure of network of author was prepared by NetDraw 2.084 and gCLUTO1.0.(2)Meta-analysis of clinical nursing pathway in patients with cervical cancer surgery:Computer retrieved was conducted to search Cochrane library,PubMed,EMBASE.com,Web of Science,Chinese Biomedical Literature Database,China National Knowledge Infrastructure,WANFANG Database and other bibliographic databases,the randomized controlled trials(RCTs)were included,which concerned on clinical nursing path for cervical cancer,and the quality of included studies were critically evaluated by Cochrane handbook,STATA13.0 was used to analysis data.(3)We conducted a clinical control trial.According to the inclusion criteria and exclusion criteria,we screened the cervical cancer in the First Hospital of Lanzhou University,and divided them into clinical nursing pathway and usual medical care.We compared respectively about hospitalization time,postoperative complications,hospitalization costs,nursing costs and patient's satisfaction.SPSS(version 19.0)software was used to analyze related data.Results(1)Primary search ended up with 10384 studies,7323 studies were included.There was a serious imbalance in the number of the distribution of authors,city and countries.Which were divided six research teams,although more and more researcher focused on the clinical nursing pathways,there must be relationships among different researchers.At the same time,there were eight research topics.(2)11 RCTs were included.The results show that clinical nursing pathway could short the hospitalization time[WMD=-4.75(95% CI:-5.83~-3.67),P=0.000],reduce the incidence of complications[OR=0.23(95% CI:0.15 ~ 0.36),P=0.000] and improve thesatisfaction of the patients[OR=6.32(95% CI:3.86~10.34),P=0.000].(3)A total of 96 patients(48patients in each group)were included,there were significant differences between clinical nursing pathway group and usual medical care in the hospitalization time(9.23±0.12 days vs 12.20±3.10days),hospitalization costs(17830.61±2582.14 yuan vs 22514.15±1809.09 yuan),nursing costs(185.70±247.9 yuan vs 280.28±213.94 yuan)and patient's satisfaction(97.92% vs 85.41%),at the same time,the results of cost effectiveness showed that clinical nursing pathway has advantages in patient's satisfaction/ hospitalization costs(182.09 yuan /% vs 263.6 yuan /%)and patient's satisfaction/nursing costs(1.9 yuan /% vs 3.28 yuan /%).Conclusion In recent years,the number of clinical nursing pathway is on a growth trend,there are many authors and institutions,but core authors were litter,at the same time,the cooperation between different authors is weak and should be strengthened,research topics still need further development.The current evidence showed that clinical nursing path could decrease the hospitalization time and incidence of complications,at the same time,improve the the patients' satisfaction.clinical trial showed that the clinical nursing pathway may be able to short the hospitalization time,decreased hospitalization costs and nursing cost,at the same time,clinical nursing pathway could improve the satisfaction and has high cost effectiveness.