PURPOSE
In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed.
METHODS
This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group.
RESULTS
The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002).
CONCLUSION
The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP.

Citations

• Factors Influencing Patient Satisfaction after Microvascular Decompression for Hemifacial Spasm: A Focus on Residual Spasms
  Jeong-A Lee, Doo-Sik Kong, Soo Jung Kim, Seunghoon Lee, Sang-Ku Park, Kwan Park
  Stereotactic and Functional Neurosurgery.2022; 100(1): 26.     CrossRef

PURPOSE
The purpose of this study was to demonstrate effects of a critical pathway (CP) for stroke patients seen in emergency rooms (ER).
METHODS
The CP developed by the CP committee consisted of 8 criteria: behavior of doctors and nurses, laboratory tests, Image testing, medication, treatment, activity, and nutrition. According to application of CP, a control group (n=17) and experimental group (n=17) were defined. Time was checked by the electronic medical records.
RESULTS
Use of CP for stroke patients in the ER, resulted in a decreased length of stay in ER (t=2.341, p=.026), and time required for image testing (t=2.623, p=.021), and an increased number of patients using rtPA (chi2=4.802, p=.049). Time required for neurology doctor contact, for neurology doctor to see patient in the ER, and for report of blood tests decreased, but there were no statistical significance.
CONCLUSION
Quick responses are most important in the ER, so CP for these patients is a very effective patient management tool. To reduce delay in stroke diagnosis, continuous education programs for similar symptoms are necessary. CPs for other patients in the ER should be developed, and studies on cost and satisfaction, as well as length of stay, should be done.

Citations

• Factors affecting the length of stay in the emergency department for critically Ill patients transferred to regional emergency medical center
  Hyungbok Lee, Sangrim Lee, Hyeoneui Kim
  Nursing Open.2023; 10(5): 3220.     CrossRef
• Development of a Critical Pathway for a Korean Medicine Hospital Inpatient with Stroke
  Mikyung Kim, Chang-ho Han
  Journal of Korean Medicine.2021; 42(2): 62.     CrossRef

PURPOSE
This study is a descriptive research to analyze prognostic factors of barbiturate coma therapy (BCT) for severe brain damage patients, to develop a critical pathway (CP) based on the results of analysis and to examine the effect of its clinical application.
METHOD
We analyzed medical records of 76 patients who received BCT for more than three days between January 1999 to July 2005. Based on the results of the analysis, we developed a CP and applied it to 12 people during August-December of 2005.
RESULT
By application of BCT CP, the mortality rate decreased from 31.6% to 16.7%. It was found that the period of staying at ICU and total period of hospitalization were shortened by 2.78 (13.9%) days and 16.43 (29.4%) days, respectively. The Glasgow coma scale of the recovery group by CP application was 9.03 (4.64) at 72 hours post of BCT and 14.28 (1.82) at discharge from hospital, and DRS was 6.62 (6.38) points.
CONCLUSION
By verifying clinical validity of the suggested CP, we believe that we have obtained visible effects standardizing the treatment pathway of BCT for brain damage patients.

Citations

• Early prediction of neurological outcome after barbiturate coma therapy in patients undergoing brain tumor surgery
  Jeong-Am Ryu, Wonkyung Jung, Yoo Jin Jung, Do Yeon Kwon, Kina Kang, Hyeok Choi, Doo-Sik Kong, Ho Jun Seol, Jung-Il Lee, Jonathan H. Sherman
  PLOS ONE.2019; 14(4): e0215280.     CrossRef
• Development and Long Term Evaluation of a Critical Pathway for the Management of Microvascular Decompression
  Jeong A Lee, Jung Sook Kim, Kwan Park, Doo-Sik Kong
  Journal of Korean Academy of Nursing Administration.2014; 20(1): 117.     CrossRef
• Reduction of Length of Stay in Emergency Room by Using Critical Pathway for Stroke Patients
  Yeo Ok Yun, Min Young Kim, Woo Jeong Kim, Young Joon Kang, Ju Ok Park, Kyung Hye Park
  Journal of Korean Academy of Nursing Administration.2011; 17(1): 66.     CrossRef