Decreased resource utilization since initiation of institutional clinical pathway for care of children with perforated appendicitis.
Document Type
Article
Publication Date
6-1-2013
Identifier
DOI: 10.1016/j.jpedsurg.2013.03.044
Abstract
Purpose: We instituted a clinical pathway for the care of patients with perforated appendicitis based on outcomes from several clinical trials. The objective of this study was to review effects on resource utilization with this protocol.
Methods: A retrospective review was conducted to compare all patients undergoing appendectomy during initial admission for perforated appendicitis prior to the pathway (July 2001 to December 2003) to after (December 2008 to March 2011). Demographics and management strategies were evaluated.
Results: Charts of 151 patients prior to and 259 after the start of the pathway were reviewed. The percentage of patients leaving the operating room with a nasogastric tube (NGT) was significantly lower in the after-group, while similar numbers of patients during each period had a NGT placed on the floor. The proportion of patients receiving peripherally inserted central catheters and total parenteral nutrition, and the number of intravenous antibiotics per day and lab draws were significantly reduced with the protocol. Patients were started on a regular diet significantly earlier, and length of stay was shortened by more than one day.
Conclusion: The evidence-based clinical pathway developed from prospective trials has drastically reduced resource utilization for children with perforated appendicitis.
Journal Title
Journal of pediatric surgery
Volume
48
Issue
6
First Page
1395
Last Page
1398
MeSH Keywords
Adolescent; Appendectomy; Appendicitis; Child; Child, Preschool; Critical Pathways; Female; Health Resources; Humans; Length of Stay; Male; Outcome and Process Assessment (Health Care); Postoperative Care; Retrospective Studies
Keywords
Children; Clinical pathway; Perforated appendicitis; Protocol; Resource utilization
Recommended Citation
Knott, E. M., Gasior, A. C., Ostlie, D. J., Holcomb, G. W., St Peter, S. D. Decreased resource utilization since initiation of institutional clinical pathway for care of children with perforated appendicitis. Journal of pediatric surgery 48, 1395-1398 (2013).
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