The Effects and Variances of the Critical Pathway of Laparoscopic Colon Resection in Colon Cancer Patients

Hye Jeong Jung; Mona Choi; So Sun Kim; Nam Kyu Kim; Kang Young Lee

doi:10.5388/aon.2012.12.3.204

Journal List > Asian Oncol Nurs > v.12(3) > 1081735

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Jung, Choi, Kim, Kim, and Lee: The Effects and Variances of the Critical Pathway of Laparoscopic Colon Resection in Colon Cancer Patients

Original Article

Asian Oncology Nursing

Asian Oncology Nursing 2012; 12(3): 204-212.

Published online: 30 September 2012

DOI: https://doi.org/10.5388/aon.2012.12.3.204

The Effects and Variances of the Critical Pathway of Laparoscopic Colon Resection in Colon Cancer Patients

Hye Jeong Jung¹, Mona Choi², So Sun Kim², Nam Kyu Kim³, Kang Young Lee³

¹Severance Hospital, Yonsei University Health System, Seoul, Korea.

²Yonsei University College of Nursing, Seoul, Korea.

³Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

Address reprint requests to: Jung, Hye Jeong. Severance Hospital, Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: +82-2-2227-3617, Fax: +82-2-313-8289, adoze@yuhs.ac

Received 3 May 2012 Accepted 13 June 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the effectiveness and variance of a critical pathway (CP) for laparoscopic colon resection in colon cancer patients, and nurses'satisfaction with the CP.

Methods

A CP for laparoscopic colon resection was applied to the CP-group that included 50 patients, who underwent elective colon resection between March and May, 2011. The non-CP group included 51 patients who had the same operation without the CP applied from March to May, 2010.

Results

The means of length of hospital stay were 11.7 and 7.3 days (p<.001) and the lengths of postoperative hospital stay were 8.6 and 5.1 days (p<.001) in the non-CP group and CP group, respectively. There was no significant difference between two groups for total healthcare costs, pain score, complications, or emergency room visits within 30 days after discharge. By examining variances of the CP, there were 162 variances and the most frequent cause was patient's condition. Nurses'satisfaction with the use of CP was favorable and the mean score of satisfaction was 3.76 on the 5 point Likert scale.

Conclusion

There are clear benefits to use of CP, resulting in standardized and effective patient care. In conclusion, analysis of variance data can assist in evaluating and revising CP for optimal care and reducing variances.

Keywords: Critical Pathways, Colonic Neoplasms, Analysis of Variance

Figures and Tables

Table 1

Demographic and Disease-related Characteristics between Non-CP Group and CP Group (N=101)

BMI=body mass index.

Table 2

Comparison of Outcomes between Non-CP Group and CP Group (N=101)

Pain score is recorded on the day of discharge with the Numerical Pain Intensity Scale (NPIS). NPIS; 11-point numerical rating scale, with 0="No pain" and 10="Pain as bad as it could be".

Table 3

Comparison of Postoperative Complications between Non-CP Group and CP Group (N=101)

^*Atelectasis, Pneumonia; ^†Urinary retention, Urinary tract infection; ^‡Multiple counts in one patient allowed; ^§Fisher's exact test.

Table 4

Contents and Frequency of Variance

Notes

This article is a condensed form of the first author's master's thesis from Yonsei University.

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