Impact of the Implementation of Clinical Pathway on Postoperative Infection Rate

Abstract

Objectives. To study the impact of the implementation of clinical pathway (CP) on the control of nosocomial infection and to provide an evidence for the management of infection. Methods. We compared and analyzed the average length of stay (LOS), antimicrobial drug usage, catheter and infection rate before and after the implementation of CP, by surveying the conditions of general surgical patients who underwent radical gastrectomy, radical resection of rectal carcinoma and modified radical mastectomy, without the implementation of CP, in 2009, and with the implementation of CP, in 2010. Results. The average LOS of the three categories of surgical patients after the implementation of the CP was significantly shortened, the average LOS of patients who underwent radical gastrectomy was shortened by 6.1 days, the average LOS of patients who underwent radical resection of rectal carcinoma was shortened by 6.29 days, and the average LOS of the patients who underwent modified radical mastectomy was shortened by 6.3 days. The antimicrobial drug usage was significantly reduced, wherein the usage of one antibacterial drug was increased by 25.05%, and the usage of a combination of two antimicrobial drugs was decreased by 19.26%; the usage of a combination of three antibiotics was decreased by 4.5%, while the usage of a combination of four antimicrobial drugs was decreased by 2.13%. The rate of nosocomial infection was decreased from 5.64% to 3.28%. The average number of days of requirement of a urinary catheter and deep vein catheterization was decreased significantly. It was statistically significant (P<0.001). Conclusions. The CP regulates the behavior of medical care staff, strengthens the execution of infection control measures, reduces the risk factors for infection, and effectively reduces the infection rates.