정상산모의 질식분만 및 제왕절개술에 대한 표준진료지침서의 개발과 임상 적용

박용원; 배상욱; 정영내; 이혜우; 김영란; 홍순복; 박현주; 탁관철

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자료유형: 학술저널

저자정보: 박용원 (연세대학교 의과대학 산부인과학 교실) 배상욱 (연세대학교 의과대학 산부인과학 교실) 정영내 (연세대학교 의과대학 산부인과학 교실) 이혜우 (연세의료원 간호부) 김영란 (연세의료원 간호부) 홍순복 (연세의료원 간호부) 박현주 (연세의료원 적정진료관리실) 탁관철 (연세의료원 적정진료관리실)

저널정보: 한국의료질향상학회 한국의료질향상학회지 한국의료질향상학회지 제7권 제1호

발행연도: 2000.1

수록면: 32 - 45 (14page)

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Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

#Critical pathway #Casarean section #Vaginal delivery

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