Efficiency of clinical nursing pathway in patients with coronary heart disease after PCI surgery: a meta-analysis

Abstract

Objective To evaluate the effects of clinical nursing pathway (CNP) on nursing effect of patients with coronary heart disease (CHD) after PCI surgery by meta-analysis. Methods Randomized controlled trials (RCTs) of clinical nursing pathway (CNP) and common nursing for patients with CHD after PIC surgery were searched in several databases including CNKI, Wanfang, and VIP, from the inception of database to August 1st 2016. Two researchers collected papers separately, and applied RevMan 5.2.0 to analyze data. Relative risk (RR) , mean difference (MD) , and 95% confidence intervals (CI) gave evidences to the outcomes. Results Totally 19 researches and 2 420 patients with CHD were included in this study. The quality of methodology in those studies was low and high risk of bias was a common limitation. Meta analysis showed that, compared with common nursing group, the incidence rate of complications in clinical nursing pathway group was lower [RR=0.42, 95%CI (0.35~0.50) , I2=0%], satisfaction level was higher [RR=1.14, 95%CI (1.11~1.18) , I2=13%], hospitalization duration was shorter [MD=-2.67, 95%CI (-3.24~-2.10) , I2=94%], and hospitalization cost was lower [MD=-0.44, 95%CI (-0.55~-0.34) , I2=100%]. Conclusions Clinical nursing pathway is effective in lowering incidence rate of complications, increasing patient's satisfaction level, shortening hospitalization duration, and cutting hospitalization cost. However, the results need more high-quality, and rigorous-designed RCTs to support. Key words: Clinical nursing pathway; Coronary heart disease; Percutaneous transluminal coronary intervention; Meta-analysis