Effect of clinical path management program based on evidence-based concept in management of bronchial pneumonia / 中国中西医结合急救杂志

ABSTRACT

Objective To explore the effect of clinical evidence management program based on evidence-based concept in the implementation of hospital bronchial pneumonia management. Methods Fifty-six patients diagnosed with bronchial pneumonia and admitted to the First Affiliated Hospital of Chongqing Medical University from January 2016 to January 2018 were enrolled. Patients were divided into study group (28 cases) and control group (28 cases). The control group was implemented routine medical management programs, including establishing cases, health education, and routine examinations; the research team was implemented the clinical pathway management scheme based on the concept of evidence-based medicine, that is, to set up a bronchopneumonia management team to manage and monitor the patient's care and treatment based on evidence-based theory, conduct regular spot checks, find problems and correct them in time, and establish a unified standardized process according to the contents specified in the clinical pathway form. The clinical efficacy, the length of hospital stay, hospitalization costs, and life quality of the patients were compared between two groups. Results The gender, age, and degree of disease of the two groups were highly balanced. Compared with the control group, the total clinical effective rate of the study group was significantly increased (92.9% vs. 71.4%, χ2= 10.746, P = 0.002), the length of hospital stay was significantly shortened (days 9.6±1.8 vs. 13.8±2.4, t = 5.927, P = 0.001), the hospitalization costs were significantly reduced (yuan 4 855.0±822.8 vs. 6 452.0±845.5, t = 6.210, P = 0.000). In addition, the scores of somatic pain, somatic function, physiological function, social function, vitality, psychological function, emotional function and overall health in the SF-36 scale in the study group were significantly higher than those in the control group [somatic pain 80.71±2.23 vs. 72.87±1.77, somatic function81.44±5.02 vs. 70.43±4.46, physiological function 82.11±3.12 vs. 71.86±3.65, social function 62.51±1.60 vs. 51.33±1.58, vitality 87.40±1.65 vs. 70.11±1.90, psychological function 82.30±1.32 vs. 75.52±1.62, emotional function 73.66±2.81 vs. 66.54±2.60, overall health 78.32±1.93 vs. 58.90±1.00, all P < 0.01]. Conclusion The evidence-based clinical path management program can significantly improve the clinical outcomes of patients with bronchial pneumonia, shorten the length of hospital stay, reduce hospitalization costs, and have higher patient life quality.