Clinical Nursing Pathway Research Articles

Application effects of clinical nursing pathway on the medication compliance of pa-tients with tuberculous pleurisy

Objective To explore the effects of clinical nursing pathway on the medication compliance of patients with tuberculous pleurisy.Methods A total of 80 patients with tuberculous pleurisy in our hospital from 2012 February to 2013 March were randomly divided into the observation group and the control group , 40 cases in each group , the control group received routine nursing care , the observation group used clinical nursing path , the nursing effects were compared between the two groups.Results The excellent and good rate of health knowledge , treatment compliance and clinical efficacy in the observation group were higher than those in the control group , the hospitalization time, the cost of hospitalization were significantly less than those in the control group with statistical significance （P〈0.05） .Life quality score in six aspects of energy, pain, sleep, social activities, emotional, physical activity before discharge in the observation group were sig-nificantly lower than those in the control group , with statistical significance （ P〈0.05 ） .Nursing satisfaction in the observation group was significantly higher than that in the control group , with statistical significance （ P〈0.05 ） .Conclusions Using clinical nursing pathway for nursing intervention can improve the compliance , therapeutic effect and life quality of patients with tuberculous pleurisy . Key words: Nursing intervention; Tuberculous pleurisy; Pathway; Compliance; Life quality

Application of clinical nursing path in children with congenital polydactyly surgery

Objective To explore the application effect of clinical nursing path in children with congenital polydactyly surgery. Methods One hundred and nine children with congenital polydactyly surgery from October 2011 to October 2013 were chosen and were divided into the intervention group (n=54) and the control group (n=55) according to the simple random sampling method. The control group received the routine nursing, and the intervention group received the nursing according to the observation form of the clinical nursing path. The average hospitalization days, the degree of pain and the average medical expenses, and the satisfaction of patient's parents were compared between two groups. Results The average hospitalization days, the degree of pain and the average medical expenses in the intervention group were respectively (4.32±0.31) d, (4.67±1.24) and (4 662.39±365.2) yuan, and were lower than (4.98±0.48) d, (5.28±1.18) and (6 038.18±285.8) yuan in the control group, and the differences were statistically significant (t=8.510, 2.631, 21.925, respectively; P<0.05). The satisfaction of patient's parents including the service attitude, health education, technical level, diet instruction, psychological support and care for children were respectively 98.15%, 96.29%, 94.44%, 98.15%, 100.00%, 98.15% in the intervention group, and were higher than 83.64%, 83.64%, 81.82%, 85.45%, 87.27%, 81.82% in the control group, and the differences were statistically significant (χ2=6.886, 4.813, 4.135, 5.796, 7.344, 8.008, respectively; P<0.05). Conclusions Application of clinical nursing path can improve the operating efficiency of the hospital, and reduce the patients' hospitalization days, and decrease the degree of pain and medical expenses, and increase the satisfaction of patient's parents. Key words: Congenital polydactyly; Clinical nursing pathway; Degree of pain; Satisfaction

Application of clinical nursing pathway in patients with hand-foot-and-mouth disease associated with vital myocarditis

Objective To study the effect of clinical nursing pathway in patients with hand-foot-and-mouth disease associated with vital myocarditis .Methods A total of 76 cases of patients with hand-foot-and-mouth disease associated with vital myocarditis between December 2011 and December 2013 were recruited and divided into control group（n=38）and observation group（n=38） randomly.The control group was treated by normal therapy , while the observation group was treated by clinical nursing pathway .The effect and satisfaction of two groups were observed and compared .Results The hospital stay of the observation group was （12.8 ± 3.58） days, which was significantly shorter than that in the control group （ 18.7 ±5.31 ） days, and the difference was statistically significant （t =9.25,P〈0.05）.The hospital cost in the observation group was reduced by almost 20%compared with the control group .The observation group had one case with nosocomial infection, while there were six cases in the control group , and the difference was statistically significant （χ2 =6.08,P〈0.05）.The satisfaction rate of the observation group was 94.74%（36/38）, while the control group was 78.95%（30/38）, and a significant difference was found （ t =14.08, P 〈0.05）.Conclusions The clinical nursing pathway applied in patients with hand-foot-and-mouth disease associated with vital myocarditis can shorten hospital stay , reduce nosocomial infection and improve the satisfaction of patients . Key words: Hand-foot-and-mouth disease; Vital myocarditis; Clinical nursing pathway

Application of clinical nursing pathway of traditional Chinese medicine on patients with limb fractures during perioperative period

Obective To discuss the application of clinical nursing pathway of traditional Chinese medicine on patients with limb fractures during perioperative period. Methods One hundred hospitalized patients with limb fractures from January 2010 to December 2012 were selected and randomly divided into the study group and the control group, each with 50 patients. The study group was given clinical nursing pathway, health guidance and health education of traditional Chinese medicine, while the control group received the conventional nursing. The satisfaction rates on nursing, rating scales on post-treatment quality of life, hospital stays and the health education time were compared between two groups. Results The average days in hospital and the time of health education were （7.2 ± 1.1 ） d, （ 11.5±4.1 ） h in the study group and （ 9.1 ± 1.8 ） d, （ 23.1 ±3.5 ） h in the control group, with statistically significant differences （ t = 6.23,7.51, respectively ; P 〈 0.05）. The satisfaction rate of patients and families, the grasp of health knowledge and the rating of life quality was respectively （98.2 ± 4.1 ）, （92.3 ±4.5 ）, （165.9 ± 20.3） in the study group, better than （90.7 ± 3.9）, （76.2 ±3.3 ）, （ 102.7 ± 21.6） in the control group, and the differences were statistically significant （ t = 7.22, 12.51,9.03, respectively; P 〈 0.05）. Conclusions The application of clinical nursing pathway of traditionalChinese medicine can reduce patient＇ s medical cost, improve nursing quality and patient＇ s quality of life. Key words: Nursing of traditional Chinese medicine ; Clinical pathway ; Limb fractures

Application of clinical nursing pathway during perioperative for patients in the department of obstetrics and gynecology

Objective To explore the application effect of clinical nursing pathway on patients in the department of obstetrics and gynecology during perioperative in order to choose the best nursing model for patients.Methods One hundred and sixty patients in the department of obstetrics and gynecology during perioperative were chosen and divided into the control group and intervention group .The control group received the traditional nursing , and the intervention group received the clinical nursing pathway on the basis of the control group .The effect of nursing was compared between the two groups .Results The average time of hospital stay and medical cost were respectively （3.63 ±1.60）d, （2 286.28 ±320.2） yuan in the intervention group, which were less than （4.68 ±2.12）d, （2 479.34 ±298.7） yuan in the control group, and the differences were statistically significant （t=3.536, 3.943, respectively; P〈0.05）.The superior ratio of mastering the health knowledge was 41.25%（33/80） in the intervention group , which was higher than 22.50%（18/80） in the control group;the satisfaction of quality of nursing was 97.50%（78/80） in the intervention group , which was higher than 76.25%（61/80） in the control group, and the differences were statistically significant （χ2 =8.213,15.841, respectively;P 〈0.05 ） .The scores of dimensions excluding the pain of body in the quality of life in the intervention group were higher than those in the control group , and the differences were statistically significant （t=3.219,15.280,8.497,20.925,2.536,3.271,16.279, respectively; P〈0.05）.Conclusions Application＆amp;nbsp;of clinical nursing pathway on patients in the department of obstetrics and gynecology during perioperative can significantly reduce the average time of hospital stay and medical cost , and improve the quality of nursing and quality of life of patients . Key words: Clinical nursing pathway; Department of obstetrics and gynecology; Perioperative

Application and effect evaluation of clinical nursing pathway in obstetrics and gyne-cology department

Objective To investigate the application effect of clinical nursing pathway on holistic nursing for normal parturition women..And explore the service methods during perinatal period by clinical record.Methods A total of 260 cases of primipara with full term normal delivery were randomly divided into two groups with 130 ceases in each ..Normal holistic nursing model was applied in the con-trol group, while in the experimental group the clinical nursing pathway was applied during puerperium .Finally, the nursing quality was compared between two groups ..Results The abilities of self-care and newborn care , awareness rate of health education knowledge as well as satisfaction to medical care service in experimental group were significantly higher than those in the control group after parturi -tion.Conclusions The normalization and routinization of clinical nursing pathway can turn nursing from passiveness to initiative .So that the patients can get best nursing service.Practice of clinical nursing pathway is an effective process to improve the nursing quality. Key words: Clinical nursing pathway; Puerperium; Nursing; Effect

Meta analysis of clinical nursing pathway appfied on patients with breast cancer surgery in China

To explore the effect of clinical nursing pathway applied on patients with breastcancer surgery. Methods Searched the CNK, IVIP, Wan fang database and CBM, collected controlled clinical trials about clinical nursing pathway applied on patients with breast cancer surgery. Then, the summary data was analyzed by RevMan 5.2 software. Results Totals of 10 controlled clinical trials were incorporated, including 904 patients with breast cancer surgery, clinical nursing pathway group had 453 patients, and control group had 451 patients. Meta-analysis showed that compared with control group, the hospital stay of clinical nursing pathway group was shorter, average cost was less and the satisfaction was higher, and the difference between the two groups had significant differences （ P 〈 0.05 ）. Conclusions Applying clinical nursing pathway in patients with breast cancer surgery can shorten the average hospital stay, reduce the hospital cost and improve the satisfaction of patients. However, randomized double-blind controlled studies with large samples are needed to further confirm the conclusion. Key words: Breast cancer; Surgery; Clinical nursing pathway; Meta analysis

Application of clinical nursing pathway on patients with agkistrodon halys snake bite

Objective To study the application effect of clinical nursing pathway on patients with agkistrodon halys snake bite. Methods A total of 65 agkistrodon halys snake bite patients were divided into the experimental group （n = 33 ） and the control group （n = 32） by using random number table method. The control group was given the conventional nursing, while the experimental group received clinical nursing pathway. Hospitalization days, expense, VAS score of local pain, grasp of health knowledge and patients＇ satisfaction rate were compared between two groups. Results There was no statistically significant difference of VAS score of local pain on the first day of hospitalization between two groups （P 〉 0.05）. On the third day, the VAS score was （1.50 ± 1.45 ） in the experimental group and （2.43 ± 1.28 ） in the control group, with statistically significant difference （ t = 2. 749, P 〈 0.01 ）. The average hospitalization days and expense were （5.21 ± 1.71 ） d and （ 1 376.40 ± 410.48） yuan in the experimental group, better than （ 6.09 ± 1.53 ） d and （ 1 597.30 ± 376.60 ） yuan in the control group, with statistically significant differences （ t = 2. 192,2. 259, respectively ; P 〈 0.05）. The score of health knowledge and satisfaction rate was （26.88 ± 2.60 ）and （98.97 ± 1.81 ）in the experimental group, higher than （ 22.28 ± 4.57 ） and （ 94.78 ± 4.11 ） in the control group, and the differences were statistically significant （ t = 4. 940,5. 383, respectively; P 〈 0. 01 ）. Conehmions Clinical nursing pathway can promote the recovery of patients with agkistrodon halys snake bite, shorten their hospitalization days, reduce their expense, and improve their health knowledge as well as satisfaction rate. Key words: Agkistrodon halys snake bite; Clinical nursing pathway; Health condition; Degree of satisfaction

The effect of clinical nursing path intervention on negative emotion and life in gynecologic laparoscopic hysterectomy

Objective To investigate the application effect of clinical nursing pathway in gynecology laparoscopic hysterectomy operation.Methods A total of 100 cases of gynecology laparoscopic hysterectomy operation patients were divided into the observation group and the control group according to different nursing methods,the control group was given routine nursing,the observation group was given clinical nursing path,nursing effects was compared between two groups.Results The scores of postoperative SDS and SAS after the operation in the observation group were significantly lower than those in the control group (P ＜ 0.05).After the operation 24 h,pain score in the observation group was significantly lower than that in the control group,the postoperative infusion volume,ambulation time,anal exhaust time,going to the toilet,eating time,complications,time of hospital stay were significantly less than those in the control group (P ＜ 0.05).Nursing satisfaction in the observation group was higher than that in the control group (P ＜ 0.05).Conclusions Clinical nursing path makes nursing more standardized,it can improve negative emotion of the patients undergoing gynecological laparoscopic hysterectomy,promote the daily living ability. Key words: Clinical nursing pathway; Laparoscopic hysterectomy; Negative emotion; Life ability

Application of clinical nursing path on patients with acute pancreatitis

Objective To discuss the effect of clinical nursing pathway （ CNP） on patients with acute pancreatitis （ AP） .Methods Totals of 246 patients with AP were randomly divided into the observation group （n=124） and the control group （n=122）.The observation group received clinical nursing pathway while the control group was given conventional nursing methods .Nursing effect was compared between two groups . Results Patients’ satisfaction rate was 96.77% in the observation group and 87.70% in the control group, with statistically significant difference （χ2 =2.83,P〈0.05）.The average stay in hospital was （16.64 ±4.15）d in the observation group and （18.77 ±5.28） d in the control group.The average cost of hospitalization was （48 972.38 ±17 362.33） yuan in the observation group and （55 728.47 ±21 932.36）yuan in the control group. Both differences were statistically significant （F=2.62, 3.91, respectively;P〈0.05）.Conclusions CNP can significantly improve the nursing quality of AP patients and reduce the medical cost . Key words: Nursing; Clinical nursing pathway; Acute pancreatitis

Effect of the nurse layered management combined with clinical nursing pathway for STEMI patients

Objective To research the effect of the layered management combined with clinical nursing pathway for STEMI patients.Methods Selected 115 STEMI patients,they were divided into control group (38 cases),the experimental groupl (37 cases),group2 (40 cases).The control group was received routine acute myocardial infarction nursing based on comprehensive nursing.The experimental groupl was received the clinical pathway taking time as horizontal axis,project as vertical axis.Based on the experimental group1,the experimental group2 was received the nurse layered management combined with clinical nursing pathway for STEMI patients.The average hospitalization days,cost,the satisfaction degree of patients,nurses and doctors were compared among three groups.Results Compared with control group,the average hospitalization days and cost obviously were lower (P ＜0.05,P ＜0.01),those of the experimental group2 were lower than those of the experimental group1 (P ＜0.01),and the latter was obviously higher than the former in the aspect of disease knowledge test (P ＜ 0.01).Before discharge and 15 days after discharge telephone return visit showed that the nursing satisfaction degree of the experimental group was obviously higher than that of the control group.In the aspect of nursing job satisfaction degree of doctor and nurse,the experimental group was obviously higher than the control group (P ＜ 0.01).Conclusions The nurse layered management combined with clinical nursing pathway for STEMI patients can effectively shorten the average hospitalization days,reduce the average hospitalization cost,promote the nursing job satisfaction,it had a good application effect and was worth popularizing in clinic. Key words: Layered management; Nursing pathway; STEMI ; Effect

Clinical effectiveness of clinical nursing pathway for patients treated by endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy

AIM: To analyze the clinical effectiveness of clinical nursing pathway(CNP) for patients treated by endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic sphincterotomy(EST).METHODS: Seventy-eight patients with extrahepatic gallstones treated at our hospital from September 2010 to August 2011 comprised a control group, and 98 patients with extrahepatic gallstones treated at our hospital from September 2011 to August 2011 comprised a treatment group. All patients received routine care, and the treatment group received CNP on the basis of routine care. Clinical effectiveness was observed and compared between the two groups.RESULTS: The hospitalization duration, hospital costs and incidence of postoperative complications in the treatment group were significantly lower than those in the control group(P < 0.05). The rates of health knowledge awareness and satisfaction to care quality in the treatment group were significantly higher than those in the control group(95.9% vs 87.2%, 96.9% vs 87.2%, P < 0.05).CONCLUSION: CNP is effective for patients treated by ERCP and EST.

Application of clinical nursing pathway in patients with acute myocardial infarction

Objective To explore the implementation effect of the clinical nursing pathway in patients with acute myocardialinfarction （ AMI） under emergency percutaneous coronary intervention .Methods A total of 360 cases of AMI were randomly divided into the control group （ n=180 ） and the observation group （ n=180 ） .The control group was nursed by the traditional method , while the observation group was nursed according to the clinical nursing pathway table .The operation time , the average days of hospitalization , hospitalization expenses, patients’ understanding of disease-related knowledge and satisfaction rate were compared between the two groups .Results The observation group , the time from admission to operation , the overall hospitalization expenses,the average of days of hospitalization ,patients’ satisfaction rate and qualified rate of nursing document writing were （65 ±20）min, （59 284.41 ±18 387.85） ten thousand yuan, （8.50 ±2.54） d,97.22% and 95.59%.While in the control group, the data were （80 ±19） min, （85 569.99 ±12 5324.77）ten thousand yuan,（11.00 ±2.97） d,88.89% and 85.18%, respectively, which showed statistically significant （ t =18.3745,28.829 0,8.5658;χ2 =9.671 6, 11.425 1,respectively;P 〈0.01）.Conclusions Nursing according to the clinical nursing pathway in patients with AMI can reduce the length of hospital stay and hospitalization expenses , improve the satisfaction of patients and the qualified rate of nursing document writing , and avoid the risk of nursing work . Key words: Acute myocardial infarction; Clinical nursing pathway; Patients’ satisfaction rate; Hospitalization expenses; Length of hospital stay

Application effect of clinical nursing pathways on acute myocardial infarction patients:A Meta-analysis

Objective To evaluate the application effect of clinical nursing pathways in acute myocardial infarction patients by using the Meta-analysis.Methods Published randomized controlled trials (RCT) in acute myocardial infarction patients were searched and screened in CNKI,VIP,Wanfang database under present standards.The quality of the included studies was evaluated by certain standards.The Review Manager 5.0 software was taken for analysis.Results Totally 18 studies including 1877 cases were eligible to the criteria (894 in the experimental group and 983 in the control group) altogether.The Meta-analysis showed there was significant difference between the experimental group and the control group in hospitalization days,patients' satisfaction degree and rate of mastering knowledge.Significant difference existed between the experimental group and the control group in bedridden time,complication rate and the recurrence rate of myocardial infarction.Conclusions Application of clinical nursing pathway in acute myocardial infarction patients can shorten hospitalization days,increase patients' satisfaction degree and rate of mastering knowledge,decrease bedridden time,complication rate and the recurrence rate of myocardial infarction. Key words: Acute myocardial infarction; Clinical nursing pathway; Meta-analysis

Research on clinical nursing path in application of VSD technology in patients in hand and foot surgery

Objective To explore the effects of clinical nursing path implement in patients with VSD technology applications.Methods We selected 82 patients with hand-foot skin defect who were treated by VSD technology applications in 2011 as the control group,and they were given routine nursing care for postoperative.Then selected 90 patients with hand-foot skin defect who were treated by VSD technology applications in 2012 as the experimental group,they were implemented with clinical nursing pathway for postoperative.We observed and compared functional exercise adherence,health education awareness rate,satisfaction and average length of stay in patients of two groups after nursing care.Results The average length of stay (16.5 days)in experimental group was apparently less than that in control group (19.5 days); the functional exercise adherence was 97.7 ％in experimental group,apparently higher than that in control group (89％); the health education awareness rate 96.8 ％ was apparently higher than that in control group (87.5 ％); the satisfaction 99.1％ in experimental group was apparently higher than that in control group (90％),there was obviously statistical significant difference between both groups (P ＜ 0.05).Conclusion Carrying out clinical nursing pathway for the patients with handfoot skin defect who were treated by VSD technology applications could improve patients' satisfaction and health education awareness rate,improve work efficiency and quality of nursing care,furthermore,shorten hospital stays,reduce hospital costs,and promote functional recovery of limb for patients. Key words: Clinical nursing pathway; VSD technology; Quality of nursing

Nursing experiences on clinical nursing pathway used for patients with chronic renal failure undergoing therapy of peritoneal dialysis

Objective To explore the nursing experiences on clinical nursing pathway (CNP) used for patients with chronic renal failure (CRF) undergoing therapy of peritoneal dialysis.Methods 98 cases of patients with CRF undergoing therapy of peritoneal dialysis were divided into control group and experimental group,control group was given routine nursing and experimental group was given CNP care.Results The acquisition of knowledge about CRF and peritoneal dialysis in two groups had no significant difference (t=1.818,P＞0.05; t=1.464,P＞0.05),diet,sports and psychological recovery in experimental group were significantly better than those in control group (t=8.330,P＜0.01 ; t=8.405,P＜0.01 ; t=8.533,P＜0.01).The mastering time of the dialysis operation in experimental group was significantly shorter than that in control group,satisfaction degree of nursing in experimental group was also significantly better than that in control group (x2=5.466,P＜0.01; x 2=5.237,P＜0.01).Conclusion The CNP nursing based on individual evaluation is meaningful for prompting integral adjustment of patients' mind and body,and shows the nursing principle of patientoriented,so it deserves consideration in clinic. Key words: Chronic renal failure (CRF); Peritoneal dialysis; Clinical nursing pathway (CNP)

Application of clinical nursing pathway for patients with schizophrenia and correlated factors with its effects

Objective The present study is to evaluate the effects of clinical nursing pathway (CNP)carried out among the in-patients with schizophrenia,and investigate its associated factors.Methods Via a random assignation,a total of 125 in-patients with schizophrenia were eligible,63 cases in the CNP group and 62 cases in the control group.CNP procedure was implemented in the CNP group,however only routine health education was carried out in the control group.In time of discharge,serial investigations were executed including hospitalization days,medical cost,knowledge about health education (KHE),and clinical global impression-global improvement (CGI-GI) and satisfaction survey (SS).Finally Logistic regression procedure was used for determining the variables associated with outcomes.Results Compared with the control group,the CNP group showed significantly higher scores in KHE and SS,but not in hospitalization days,medical cost and eficacy.Mono-variant and multivariate Logistic regression analysis indicated that in the CNP group,only age and education levels were the factors significantly related with CNP effects.Conclusions Our result displays that CNP is profitable to be carried out in psychiatric department.It can improve relationship between nurses and patients,enhance health education effect,and thus contribute to increasing compliance to antipsychotics. Key words: Clinical pathway; Nursing care; Schizophrenia; Related factors

The effect of clinical nursing pathway on lung function and nursing satisfaction in pneumonia patients

Objective To investigate the application effect of clinical nursing pathway on pneumonia patients.Methods Totaled of 100 cases of pneumonia patients were divided into the observation group and the control group according to different nursing methods,the control group was given routine nursing,the observation group was given clinical nursing pathway,and nursing effects were compared between the two groups.Results PCO2 before discharge in the observation group was significantly less than that in the control group,PO2,PEF were significantly higher than those in the control group (P ＜ 0.05).The disappeared time of cough,asthma,pulmonary symptoms and hospitalization time in the observation group were significantly shorter than those in the control group (P ＜ 0.05).Nursing satisfaction in education,environment,attitude project in the observation group were significantly higher than those in the control group (P ＜ 0.05).Conclusions Clinical nursing path can significantly improve the therapeutic effect in pneumonia patients,improve lung function,and shorten the hospitalization time. Key words: Clinical nursing path; Pneumonia; Pulmonary function ; Nursing satisfaction

Application of clinical nursing pathway on patients with femoral neck fracture

Objective To investigate the effect of clinical pathway on the nursing of patients with femoral neck fracture.Methods Patients with femoral neck fracture were randomly divided into the experimental group and control group.The conventional way of nursing was applied to the control group,while the clinical nursing pathway was applied to the experimental group.Effects of nursing were evaluated by the Symptom Checklist 90 (SCL-90) and satisfaction questionnaire.Results Scores on fear,interpersonal sensitivity,anxiety and depression for the experimental group were significantly lower than those of the control group (P ＜ 0.05).Compared with that of control group,the satisfaction for the nursing work in the experimental group was obviously enhanced (98.7％ vs 87.25％) while the average hospitalization day was significantly reduced (P ＜ 0.01).Conclusions Clinical nursing pathway can decrease the bad psychological reaction,enhance the nursing quality and satisfaction,shorten the hospitalization days and reduce the treatment cost. Key words: Femoral neck fracture; Clinical pathway; Nursing

Clinical nursing pathway model for criticallyi1l children

Objective To evaluate the effect of clinical nursing pathway model for critically ill children.Methods 60 critically ill children,including 40 cases with hand-foot-mouth desease and viral encephalitis,12 cases with severe pneumonia,and 8 cases with severe diarrhea,were selected and then were randomly divided an observation group and a control group,30 for each group.The observation group were nursed according to the clinical nursing pathway,while the control group were nursed in term of routine nursing mode.Results The average hospital stay was markedly shorter in the observation group than in the control group[(10.7 ± 2.3)d vs.(15.5 ± 2.6)d].28 cases in the observation group and 18 cases in the control group had good command of health knowledge,with a statistical difference(P＜0.05).Conclusion Clinical nursing pathway for acute and critically ill children can significantly shorten hospital stay,improve nursing quality,and significantly increase patients' satisfaction rate. Key words: Clinical nursing; Pathway model; Serious illness