The application of perioperative clinical pathway for severe preeclampsia patients in intensive care unit

Abstract

To evaluate the effect of implementation of perioperative clinical pathway (CP) for severe preeclampsia patients in intensive care unit (ICU), and to discuss variation factors in order to improve clinical quality. Thirty-six patients treated in ICU in the Second Clinical Hospital of Fujian Medical University were divided into two groups according to time of 1 year before implementation of CP (from January to December in 2009, n=14) and 1 year after implementation of CP (from January to December in 2010, n=22). The length of stay in ICU, cost of hospitalization, occurrence of major complications and mortality, as well as the total effective rate of control of blood pressure in the first 3 days after operation were compared. Compared with the group of patients of 1 year before implementation of CP, in the group of patients of 1 year after implementation of CP, the length of stay in ICU (hours) was significantly shorter (65.5±24.9 vs. 86.3±28.2, t=2.321, P<0.05), the cost of hospitalization (yuan) was significantly lower (6 463.6±1 838.2 vs. 8 136.5±2 142.8, t=2.496, P<0.05), the occurrence rate of major complications was lower (36.4% vs. 42.8%, χ2=0.100, P>0.05), the total effective control rate of blood pressure was significant improved on the 1st and the 2nd postoperative day (1 day: 59.1% vs. 14.3%, 2 days: 86.4% vs. 50.0%, both P<0.05), but there was no significant change on the 3rd postoperative day (95.4% vs. 85.7%, P>0.05). One patient died before the application of CP, and none after its application. These results suggested that it was beneficial to implement the program in preeclampsia patients to improve medical quality.