J Korean Acad Nurs Adm.  2011 Mar;17(1):66-73.

Reduction of Length of Stay in Emergency Room by Using Critical Pathway for Stroke Patients

Affiliations
  • 1Emergency Medical Center, Jeju National University Hospital, Korea.
  • 2College of Nursing, Jeju National University, Korea. musemy2@hanmail.net
  • 3Department of Emergency Medicine, School of Medicine, Jeju National University, Korea.

Abstract

PURPOSE
The purpose of this study was to demonstrate effects of a critical pathway (CP) for stroke patients seen in emergency rooms (ER).
METHODS
The CP developed by the CP committee consisted of 8 criteria: behavior of doctors and nurses, laboratory tests, Image testing, medication, treatment, activity, and nutrition. According to application of CP, a control group (n=17) and experimental group (n=17) were defined. Time was checked by the electronic medical records.
RESULTS
Use of CP for stroke patients in the ER, resulted in a decreased length of stay in ER (t=2.341, p=.026), and time required for image testing (t=2.623, p=.021), and an increased number of patients using rtPA (chi2=4.802, p=.049). Time required for neurology doctor contact, for neurology doctor to see patient in the ER, and for report of blood tests decreased, but there were no statistical significance.
CONCLUSION
Quick responses are most important in the ER, so CP for these patients is a very effective patient management tool. To reduce delay in stroke diagnosis, continuous education programs for similar symptoms are necessary. CPs for other patients in the ER should be developed, and studies on cost and satisfaction, as well as length of stay, should be done.

Keyword

Critical pathways; Length of stay; Stroke; Emergency service

MeSH Terms

Critical Pathways
Electronics
Electrons
Emergencies
Hematologic Tests
Humans
Length of Stay
Neurology
Stroke
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