クリティカルパス導入後の直接ケア時間の変化　　ＫＮＳによる泌尿器科病棟の分析

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  • Effects of the introduction of critical paths on the direct patient care time
  • クリティカルパス ドウニュウ ゴ ノ チョクセツ ケア ジカン ノ ヘンカ : KNS ニ ヨル ヒニョウキカ ビョウトウ ノ ブンセキ
  • KNSによる泌尿器科病棟の分析

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[Objective/Aims] To see any difference in the direct patient care time before and after the introduction of critical paths (CP) to daily practice in a university hospital setting.<BR>[Methods] We analyzed the patient care time of nurses working in the urology ward, where CP were used in approximately 36% of the in-hospital patients. The investigation periods were between April 1998 and July 2000 (the number of CP was 4 or less during this period, i.e. before introducing CP), and between August 2000 and January 2002 (after the introduction of CP; the number of CP was 12). The patient care time was calculated from the database of the Kitasato Nursing System (KNS). Other statistical variables related to hospital business control were analyzed as well.<BR>[Results] The cumulative direct patient care time of the ward was decreased from the mean of 3418 to 3204 minutes per day after the introduction of CP. However, there was no difference in the direct care time per patient before and after the introduction of CP, which were 94.2 and 92.3 minutes per day, respectively. When looking at other factors, the average in-hospital days before and after the introduction of CP were 17.2 and 12.7 days /patient, respectively; the utilization rates of hospital beds were 1.8 and 2.4 cycles/month; the average numbers of patients being admitted, discharged, and in-hospital on one day were 36.3 and 34.7 patients/day; and the rates of in-operation hospital beds were 95.2 and 91.1%.<BR>[Discussion/Conclusion] It is considered that the standardization of treatment and care with the use of CP has facilitated patients to start postoperative self-care much earlier, and also that the time expended on indirect nursing businesses has been decreased greatly after introducing CP. These results suggest that the hospital business management has been improved by the introduction of CP without affecting the direct patient care time as well as the quality of care.

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