THE IMPLEMENTATION OF ACUTE APPENDICITIS CLINICAL PATHWAY TOWARD AVERAGE LENGTH OF STAY

Abstract

Acute appendicitis is a gastrointestinal disease that the incidence of it was increased in Indonesia from 566132 people in 2009 became 621435 in 2010. Cases of acute appendicitis were continued to increase every year at Condong Catur Hospital. A clinical pathway ideally suited to the management of common surgical conditions with well-defined outcomes, such as appendicitis. Implementation of the clinical pathway as clinical guidance needed to be measured to find out the impact on the outcome of the patient. This study aims to find out a significant impact of acute appendicitis clinical pathway toward the average length of stay. This study used a cross-sectional design, carried out at Condong Catur Hospital. Data were collected from the medical records of patients, both before (52 medical records) and after (50 medical records) the clinical pathway was implemented. Frequency distribution result was performed using descriptive statistics. The chi-square test was performed to find out the significant difference between variables. This study noted the majority of acute appendicitis patient occurred at 15-24 years old and male sex. Majority of the medical records of the patient is without clinical pathway. Most of the medical records with the clinical pathway are incomplete in filling on psychosocial counselling, education and communication with patient and family, and discharge planning. The mean of average length decrease from 3.52 days become 2.36 days. There is a significant difference between the implementation of a clinical pathway toward AvLOS with p-value = 0.000. There is a significant relationship between the implementation of clinical pathway appendicitis acute toward reduced of AvLOS. The hospital needs to maintain compliance in the filling of clinical pathway among physicians through regular monitoring or socialization.