臨床路徑對冠狀動脈繞道手術病患住院天數之影響

本文是以北部某醫學中心的20位冠狀動脈繞道手術(CABG)病患為例，分別比較未實施臨床路徑前，以及實施初期、實施兩年後之病患住院天數的差異。分析結果發現：實施臨床路徑兩年後的總住院天數平均約需17.95天，比實施初期少了4.25天，有明顯縮短的成效(p=0.021)。改進的變異量包括：病人變異量、工作人員變異量、系統變異量、以及社區變異量等四方面。為了順應此一轉變，醫療人員應簡化醫療處置或護理作業，以提高醫療效率及效益，並達到提升照護品質、縮短住院天數與降低成本。

關鍵字

臨床路徑；住院天數；冠狀動脈繞道手術

並列摘要

Patients received coronary artery bypass graft (CABG) were selected as examples to describe the changes during the implementation of clinical pathway in a medical center around the northern part of Taiwan. A total of20 cases was selected during the three periods of before implementation, the early stage of implementation, and 2 years later. The results indicated that length of stay (LOS) after 2 years was 17.95 days where was the LOS is 13.7 days in the early stage of implementation. Variances such as: patient's variance； practitioner variance; system variance; and community variance had been improved. The medical staff should simplify the medical and nursing interventions as ways of improving the efficiency of clinical pathway. Then, adequate quality of care, shorter length of stay, and cost saving can be achieved.

並列關鍵字

clinical pathway ； length of stay(LOS) ； coronary artery bypass graft(CABG)

被引用紀錄

顏淑婷（2014）。重大外傷病人於外傷科成立前後醫療資源耗用及醫療品質差異分析〔碩士論文，義守大學〕。華藝線上圖書館。https://doi.org/10.6343/ISU.2014.00214

延伸閱讀

吳燕惠、許淑蓮（2002）。冠狀動脈繞道手術住院病人之健康照護需求。台灣醫學，6(3)，288-304。https://doi.org/10.6320/FJM.2002.6(3).02
洪素鶯、吳英黛、曹昭懿、週正亮、楊銘欽、王水深（2004）。門診運動訓練對冠狀動脈繞道手術病患品質調整存活時間之影響。物理治療，29(6)，374-383。https://www.airitilibrary.com/Article/Detail?DocID=15632555-200412-29-6-374-383-a
Chiu, C. M., Chen, K. C., Wang, C. T., & Chou, C. L. (2015). 冠狀動脈繞道手術病人手術風險與心肺適能之相關性研究. 台灣復健醫學雜誌, 43(2), 83-89. https://doi.org/10.6315/2015.43(2)02
劉曉蓉（2007）。冠狀動脈疾病病患接受不同心臟血管支架處置之臨床療效及成本效果分析〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-2207200717073400
Yu, H. Y., Wu, I. H., Chen, Y. S., Chi, N. H., Hsu, R. B., Tsai, C. H., Wang, S. S., & Lin, F. Y. (2003). Comparison of Outcome of Off-Pump Coronary Artery Bypass Surgery and Conventional Coronary Artery Bypass Surgery. Journal of the Formosan Medical Association, 102(8), 556-562. https://doi.org/10.29828/JFMA.200308.0007

國際替代計量

臨床路徑對冠狀動脈繞道手術病患住院天數之影響

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