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Journal of Korean Society Quality Assurance Health Care 2000;7(1): 32.
Published online May 30, 2000.
정상산모의 질식분만 및 제왕절개술에 대한 표준진료지침서의 개발과 임상 적용
박용원1, 배상욱1, 정영내1, 이혜우2, 김영란2, 홍순복2, 박현주3, 탁관철3
1연세대학교 의과대학 산부인과학 교실
2연세의료원 간호부
3연세의료원 적정진료관리실
Development and Clinical Application of Critical Pathways for Vaginal Delivery and Cesarean Section
Yong Won Park1, Sang Wook Bai1, Young Nae Jung1, Hae Woo Lee2, Young Ran Kim2, Sun Bok Hong2, Heun Ju Park3, Kwan Chul Tark3
1Department of Obstetrics and Gynecology, College of Medicine, Yonsei University
2Department of Nursing, Yonsei University Hospital
3Department of Quality Improvement, Yonsei University Hospital
Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction.
Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge.
Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.
Key words Critical pathway;Casarean section;Vaginal delivery;


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