ObjectiveTo systematically review the effetcs of clinical nursing pathway (CNP) in patients with femoral neck fracture. MethodsDatabases including PubMed, The Cochrane Library (Issue 9, 2014), CNKI, VIP and WanFang Data were electronically searched to collect randomized controlled trials (RCTs) about CNP in management of patients with femoral neck fracture from inception to September 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.1 software. ResultsA total of 24 RCTs involving 1 852 patients were included. The results of meta-analysis showed that: compared with the control group, the time of hospitalization was decreased (MD=-4.47, 95%CI -5.32 to -3.62, P<0.000 01), the patients' nursing satisfaction was increased (OR=5.52, 95%CI 3.75 to 8.14, P<0.000 01), the achievement rate of knowledge was increased (OR=5.97, 95%CI 3.57 to 9.96, P<0.000 01) and the incidence of postoperative complications was decreased (OR=0.34, 95%CI 0.24 to 0.48, P<0.000 01) in the CNP group. ConclusionCNP can reduce the time of hospitalization, improve patients' nursing satisfaction, improve the achievement rate of knowledge, as well as reduce the incidence of postoperative complications. Due to limited quality and quantity of the included studies, the above conclusion need more high quality studies to verify.
ObjectiveTo systematically review the efficacy of clinical nursing pathway (CNP) in patients with esophageal cancer surgery. MethodsDatabases including PubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang Data and CNKI were electronically searched to collect randomized controlled trials (RCTs) involving the comparison of CNP with routine nursing pathway in patients with esophageal caner surgery. The retrieval time was from inception to October 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then data was analyzed by RevMan 5.2 software. ResultsA total of 16 RCTs involving 1 457 patients were included. The results of meta-analyses showed that:compared with the routine nursing pathway, the CNP could increase patients' nursing satisfaction (OR=8.08, 95%CI 5.12 to 12.74, P<0.000 01), the achievement rate of knowledge (OR=4.13, 95%CI 2.44 to 6.98, P<0.000 01) and decrease the incidence of postoperative complications (OR=0.21, 95%CI 0.13 to 0.33, P<0.000 01), the length of hospitalization (MD=-4.57, 95%CI -5.57 to -3.56, P<0.000 01). ConclusionThe clinical nursing pathway can improve patients' nursing satisfaction, the achievement rate of knowledge, it can also reduce the incidence of postoperative complications and the length of hospitalization.
ObjectiveTo explore the application and effect of clinical nursing pathway based on information-knowledge-attitude-practice (IKPA) theory in percutaneous renal needle biopsy.MethodsThis is a historical control study. A total of 460 patients who underwent percutaneous renal biopsy in West China Hospital of Sichuan University between April and December 2020 were prospectively recruited as the pathway group, and a clinical nursing pathway based on IKAP theory was implemented. By contrast, the data of 617 patients who underwent percutaneous renal biopsy and received routine care in the same hospital between April and December 2019 were retrospectively collected as the control group. The length of hospital stay, hospitalization expenses, the incidences of postoperative complications (macroscopic haematuria, perirenal hematoma, and acute urinary retention), the incidence of postoperative postural hypotension, and the management enrollment rate of chronic kidney disease patients were compared between the two groups.ResultsThe length of hospital stay [median (lower quartile, upper quartile): 8 (7, 11) vs. 8 (7, 12) d] and the hospitalization expenses [median (lower quartile, upper quartile): 7380.50 (6401.86, 8789.21) vs. 8167.00 (6816.50, 10044.50) yuan] were less in the pathway group than those in the control group, the incidences of postoperative macroscopic haematuria (1.52% vs. 6.97%) and perirenal hematoma (2.61% vs. 5.02%) were lower in the pathway group than those in the control group, the management enrollment rate of chronic kidney disease patients was higher in the pathway group than that in the control group (26.09% vs. 6.16%), and the differences between the two groups were statistically significant (P<0.05). The differences in the incidences of acute urinary retention (8.26% vs. 11.18%) and postoperative postural hypotension (0.00% vs. 0.81%) between the two groups were not statistically significant (P>0.05).ConclusionThe application of clinical nursing pathway in percutaneous renal needle biopsy can effectively reduce the length of hospital stay and hospitalization expenses, and improve the management enrollment rate of chronic kidney disease patients.