Abstract
Background: Utilization of a multidisciplinary clinical pathway during care of women undergoing hysterectomy is considered to be more effective during women' management than routine hospital care.Aim: This study was conducted to investigate the effect of clinical pathway of postoperative nursing care on improving postoperative outcomesfor women undergoing hysterectomy. Design: A quasi experimental design (study and control group). Settings: The gynecology and obstetrics departments at two hospitals affiliated to University Hospital and Shebin El-Kom teaching hospital, Menoufia Governorate. Subjects: 100 women who are undergoing hysterectomywere selected. Tools: three instruments were used for data collection;a structured interviewing, numeric pain intensity scaleandpatient satisfaction record.Results: The current study shows that women underwent hysterectomy in the study group were significantly more likely to experience less mean pain score, lesser need for analgesiaand Significant differences in the length of stay were observed compared to those in the control group.Significant differences in the early oral intake, postoperative bowel mobility and need to antiemetic drugswere observed between the study and the control groups. Concerning women’s satisfaction related to the care provided,the score given was mostly satisfied and neutral. Conclusion: application of clinical pathway improving postoperative pain successfully, short length of stay postoperative outcomes related to early ambulation, early oral intake, and bowel mobility, hours to remove catheters and drains and patient satisfaction. Recommendation: Sit is recommended to generalize application of clinical pathways in other clinical areas to improve patient outcomes and reduce postoperative complications.
Highlights
Hysterectomy is one of the world's most prevalent gynecological procedures, with around600,000 women undergoing hysterectomy every year(Wright et al, 2013)
Clinical pathways are commonly utilized in hospitals to control treatment processes through surgical specialties to increase the effectiveness of care (Qualtrics Survey Service, 2017),and minimize the average length of stay of women by 40 percent for hysterectomy surgery(Stang et al, 2014).In addition clinical pathways optimize the multi health care team's knowledge and reduce practice inconsistency as it has a positive impact on team work, involving: improved team coordination, better professional documentation, and decrease risk of burnout and tasks orientation (Desai et al, 2016)
The hysterectomy pathway should be developed through the cooperative endeavor of the health care givers such as physicians, nurses, pharmacists and others to increase the quality and value of women's care (Borah et al, 2016).It combines nursing care plans, medical care, and other health care-related into a single care plan that precisely describes a patient's planned success and outcomes across the healthcare system (Hripcsak et al, 2016).It is the responsibility of nurses to initiate and upgrade the professional pathway used to guide and assess women's healthcare and to ensure that the various best practice events take place in a manner that a multidisciplinary team will adopt and end the chain of workers included in providing care
Summary
Hysterectomy is one of the world's most prevalent gynecological procedures, with around600,000 women undergoing hysterectomy every year(Wright et al, 2013). Clinical pathways are commonly utilized in hospitals to control treatment processes through surgical specialties to increase the effectiveness of care (Qualtrics Survey Service, 2017),and minimize the average length of stay of women by 40 percent for hysterectomy surgery(Stang et al, 2014).In addition clinical pathways optimize the multi health care team's knowledge and reduce practice inconsistency as it has a positive impact on team work, involving: improved team coordination, better professional documentation, and decrease risk of burnout and tasks orientation (Desai et al., 2016). Conclusion: application of clinical pathway improving postoperative pain successfully, short length of stay postoperative outcomes related to early ambulation, early oral intake, and bowel mobility, hours to remove catheters and drains and patient satisfaction
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