Open Access, Peer-reviewed
pISSN 1225-9330
eISSN 2288-4955
    J Korean Acad Nurs Adm. 2011 Mar;17(1):66-73. Korean.
    Published online Mar 31, 2011.
    https://doi.org/10.11111/jkana.2011.17.1.66
    Copyright © 2011 Korean Academy of Nursing Administration
    Original Article

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

    Yeo Ok Yun,1 Min Young Kim,2 Woo Jeong Kim,3 Young Joon Kang,3 Ju Ok Park,3 and Kyung Hye Park4
      • 1Nurse Manager, Emergency Medical Center, Jeju National University Hospital, Korea.
      • 2Instructor, College of Nursing, Jeju National University, Korea.
      • 3Assistant Professor, Department of Emergency Medicine, School of Medicine, Jeju National University, Korea.
      • 4Instructor, Department of Emergency Medicine, School of Medicine, Jeju National University, Korea.
    • Correspondence: Kim, Min Young. Instructor, College of Nursing, Jeju National University 1, Ara 1dong, Jeju city, Jeju Special Self-Governing Province, 690-756, Korea. Tel: 82-64-754-3750, Fax: 82-64-702-2686, Email: musemy2@hanmail.net
    Received November 12, 2010; Revised January 18, 2011; Accepted January 18, 2011.

    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 (χ2=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.

    Keywords
    Critical pathways; Length of stay; Stroke; Emergency service

    Tables

    Table 1
    Schedule for this study

    Table 2
    Checklist for this study

    Table 3
    Critical pathway for acute stroke patients in emergency room

    Table 4
    Cross-tabulation of this study (n=32)

    Table 5
    Effects of critical pathway for acute stroke patients

    References

      1. Choi JY, Jang KS, Choi EY. Development of a critical pathway for the chemotherapy of non-small call lung cancer patients and its effects. J Korean Acad Nurs Adm 2002;8(1):85–95.
      1. Espinosa-Aguilar A, Reyes-Morales H, Huerta-Posada CE, de Leon IL, Lopez-Lopez F, Mejia-Hernandez M, et al. Design and validation of a critical pathway for hospital management of patients with severe traumatic brain injury. J Trauma 2008;64(5):1327–1341.
      1. Hong YM. Developing activity based clinical pathway for patients with total hip replacement. J Korean Acad Nurs Adm 2002;8(4):669–689.
      1. Kim EO. In: Effects of a standardized critical pathway in gastrectomy patients. Seoul: Seoul National University; 2004.
        Unpublished doctoral dissertation.
      1. Kim GY. Development of a critical pathway for patients with coronary artery bypass graft. J Korean Acad Nurs 1998;28(1):117–131.
      1. Kim JJ, Kim NC, Kim MJ, Kim OS, Kim YS, et al. In: Medical Surgical Nursing. Seoul: Hyunmoon publishing; 2005.
      1. Kim JS. Development of a critical pathway of barbiturate coma therapy in the management for severe brain damage. J Korean Acad Nurs Adm 2010;16(1):59–72.
      1. Kim MJ, Lee JA, Song HS, Kim ES, Yeon MJ, Cho SH. The development of the critical pathway and nursing record for patients received FP chemotherapy. J Korean Acad Adult Nurs 1999;11(4):845–857.
      1. Kim SS, Roh YS. Development of critical pathway for the patients follwing lumbar laminectomy. J Korean Acad Adult Nurs 1999;11(4):772–784.
      1. Korea National Statistical Office2008 Survey of Causes of Death. 2008 [Retrieved September 30, 2009].
        from http://kostat.go.kr/portal/korea/kor_nw/3/index.board?bmode=read&aSeq=177422.
      1. Korean Stroke SocietyWhat is the stroke?. 2005 [Retrieved January 18, 2010].
        from http://www.stroke.or.kr/stroke/index.html.
      1. Latini EE, Foote W. Obtaining consistent quality patient care for the trauma patient by using a Critical Pathway. Crit Care Nurs Q 1992;15(3):51–55.
      1. Lee MO, Chang MO. Development of the critical pathway for the patient with tonsillectomy. J Korean Acad Nurs 2003;33(7):885–894.
      1. Lee MK, Doh BN. Effects of critical pathway (CP) on the patients with primary total hip replacement (THR). J Korean Acad Nurs Adm 2002;8(2):295–308.
      1. Lim YJ, Jeong KI, Jeong HY, Sun JJ, Kim YK, Choi JK, et al. Analysis of performance on activities in critical pathway of total hip replacement surgery. J Korean Acad Adult Nurs 2006;18(5):819–827.
      1. Ministry of Health and Welfare2001 National Health and Nutrition Survey. National Health and Nutrition Survey; 2002 Dec 30 [Retrieved September 30, 2010].
        from http://www.mw.go.kr/user.tdf.
      1. National Emergency Medical CenterAppraisal of Emergency Medical Center. 2007 [Retrieved August 20, 2010].
        from http://www.nemc.or.kr/infor/infor_test_info.jsp.
      1. Noh GO, Park KS. Critical pathway development for the hysterectomy patients and its applied effect. J Korean Acad Womens Health Nurs 2000;6(2):234–257.
      1. Park JJ, Park HS. Development of a critical pathway for patients with lumbar laminectomy. J Korean Acad Adult Nurs 2000;12(4):517–532.
      1. Roh JS. Development of critical pathway for patients with lobectomy and pneumonectomy. J Korean Acad Nurs Adm 2004;10(3):345–364.
      1. Park SA. In: Nursing management. Seoul: Parkmungak; 2005.
      1. Young J, Murray J, Forster A. Review of longer-term problems after disabling stroke. Rev Clin Gerontol 2003;13(1):55–65.
    Cited by
    Crossref 2
    Google Scholar 
    MeSH Terms
    Critical Pathways
    Electronics
    Electrons
    Emergencies
    Hematologic Tests
    Humans
    Length of Stay
    Neurology
    Stroke
    Metrics
    Share
    Tables
    slide
    slide
    slide
    slide
    slide

    1 / 5

    PERMALINK