The Study Of Effect Evaluation On Application Of Senile Cataract Phacoemulsification Clinical Pathway In The Third-level Hospitals

Background:Senile cataract is top one on the list of disease that results in blindness for human. How to use the limited medical resources to restore vision for cataract patients is one of important topics faced with ophthalmology profession and public health researchers.Clinical pathway is an effective medical quality management method. It is the most appropriate, timely and sequential treatment method that doctors, nurses and other medical staff make for some particular disease diagnosis and operation in order to reduce the recovery latency and resource waste. As the effective medical management mode, clinical pathway is to provide efficient, high-quality, cheap and fast health service for the patients according to clinical pathway process and specification. Therefore, it shows great application prospects and needs to be explored constantly by medical workers. In December8,2009, the Ministry of health of the People’s Republic of China clearly declared:to select at least50pilot hospitals throughout the country, to undertake22major112disease clinical pathway management pilot work. As an essential part of the reform of public hospitals, the pilot of clinical pathway management trial started in2010. From the point of view, the clinical pathway management has already been proposed by health authorities, and in clinical pilot. And it has been taken as a way of medical management and medical content.Clinical pathway is widely applied and promoted in some hospitals abroad, while it is still in early stage in China. Also, most of the study of clinical pathway in our country is in theory and applied research is relatively rare. It has not formed a complete theoretical system. Domestic medical workers are not familiar with it. The clinical pathway in senile cataract blindness augmentation of application and research has not been studied much.Based on the situation of our country and abroad, the requirement of the policy, and experience, the treatment of phacoemulsification in senile cataract has been selected as the clinical pathway pilot after discussion with the hospital’s leaders high attach since it is with a high incidence, relatively small illness variation, obvious treatment effect, rich treatment experience. We actively developed the treatment of phacoemulsification in age-related cataract clinical pathway.Objective:Senile cataract phacoemulsification scheme is selected as the clinical path through repeated research. Practice protocol and forms are designed. Compared with the controlled group, the implementation effect of senile cataract clinical path is analyzed and evaluated. The aim of the paper is to provide the reference obtained from the research to other diseases that will be in the clinical path.Methods:An implementation scheme of senile cataract phacoemulsification clinic path is designed.120cases of senile cataract treated using clinic pathway are collected from March to November2011as the experimental group, and120cases of senile cataract treated using traditional treatment are collected from March to November2010as the controlled group. The difference of average length of stay, hospitalization cost, patient satisfaction, and health knowledge and complication rate between the two groups is compared and evaluated.Results:There is significant difference in average length of stay, hospitalization cost, patient satisfaction, health knowledge possession rate and complication rate between experimental group and controlled group. The average length of stay is3.22 days in experimental group and4.18days in controlled group; hospitalization cost is3437.87yuan and4097.77yuan; patient satisfaction is96.67%and83.33%; health knowledge possession rate is93.33%and86.67%; and the complication rate is0.5%and1.16%, respectively, the use of antibacterial medicine reduced from100%to0%,respectively.Conclusion and suggestion:Implementing the clinical pathway program requires effective communication and coordination of multiple departments and medical staff. In order to implement the clinic pathway successfully, it needs to choose the suitable disease used in the clinic pathway. We preferred the senile cataract phacoemulsification as the first one to be used in clinical pathway. It is found that the average length of stay in hospital reduced, hospitalization cost is lower, the post-operative complication rate decreased, patient satisfaction improved, the service process is optimized, sense of nurses self-esteem improved, the quality of care raised, the use of medical resources was promoted, and humanization services was achieved through the implentation of clinical path program. Moreover, this kind of service gradually becomes the standard of practicing. This paper could provide experience and evidence to the implementation of clinical pathways for other diseases in the future.