Application Research Of Clinical Pathway On Endoscopic Resection Of Gastric Polyps

Objective: To study the significance of clinical pathway on endoscopic resection ofgastric polyps.Methods:1.Found the organization group for clinical pathway in The SecondAffiliated Hospital of Dalian Medical University, and to definate of responsibility;2.Investigated base line before the practice of clinical pathway in endoscopicresection of gastric polyps;3.Combined ZhongLian Clinical Pathway Managementsoftware to hospital information system (HIS);4.Established text file and list form ofclinical pathway for doctors, nurses and patients;5.Mobilized the staff beforepracticing clinical pathway administration;6.Practiced clinical pathwayadministration from September2011on endoscopic resection of gastric polyps;7.Established evaluation plan;8.74patients underwent endoscopic resection of gastricpolyps from September2010to August2011without clinical pathway practice wereselected as the control group; While78patients underwent endoscopic resection ofgastric polyps from September2011to August2012with clinical pathway practicewere selected as the clinical pathway group.The differences in age, sex and basicdiseases (including chronic gastritis, reflux esophagitis，hypertension,diabetes mellitus)had no statistics siganificant (P>0.05). The traditional treatment ways were used in thecontrol group, the clinical pathway treatment ways were used in the clinical pathwaygroup. The average hospitalization days,average hospitalization days beforeoperation,average hospitaliztion charge,average hospitalization medicinecharge,patients’ satisfaction rate were compared between the two groups. The datawas analysed by SPSS13.0statistic software. The measurement data was expressed as （X±S）,the t test was employed,while the enumeration data was annalysed byWilcoxon test. Statistic significant was judged if P<0.05.Results:The average hospitaliztion days of congtrol group was7.5±2.8days,theaverage hospitaliztion days before operation was2.0±1.6days,the averagehospitaliztion charge was6144.50±3609.33RMB,the average hospitaliztion medicinecharge was2738.19±1689.84RMB;The average hospitaliztion days of clinicalpathway group was6.4±1.9days,the average hospitaliztion days before operation was1.4±0.9days,the average hospitaliztion charge was5231.49±1706.60RMB,theaverage hospitalization medicine charge was1935.68±841.76RMB,all the data of theclinical pathway group was lower than the control group，there’s statistic significantdifference between two groups (P<0.05).The average hospitaliztion days of clinicalpathway group was1.06days shorter than the control group(95%Confidence Intervalof the Difference was0.30-1.83), the average hospitaliztion days before operation ofclinical pathway group was0.59days shorter than the control group(95%ConfidenceInterval of the Difference was0.17-1.01), the average hospitalization charge ofclinical pathway group was913.00RMB less than the control group(95%ConfidenceInterval of the Difference was15.48-1810.53),the average hospitaliztion medicinecharge of clinical pathway group was802.51RMB less than the control group(95%Confidence Interval of the Difference was369.62-1235.39). The patients’ satisfactionrate of control group was92%, while the rate of clinical pathway group was99%.There was statisticly significant difference between two groups (P<0.05).Conclusions:Practicing the clinical pathway administration to the patients withendoscopic resection of gastric polyps is a new scientific hospital management mode,which can shorten the hospitaliztion days and the hospitaliztion days before operation,reduce the hospitaliztion charge and the hospitaliztion medicine charge, advance thepatients’ satisfaction.