Effects of clinical pathway in high risk coronary artery bypass graft patients’ outcomes
Keywords:
high risk group, coronary artery bypass graft, clinical pathway, hospital readmission, self-care knowledge, satisfactionAbstract
This study aimed to develop clinical pathway for high risk coronary artery bypass graft (CABG) patients, to exam effects of the clinical pathway on knowledge of high risk coronary artery bypass graft patients before and after the surgery as well as to evaluate both patients and the care providers’ satisfaction with the clinical pathway. The samples consisted of 40 high risk CABG patients with left ventricular ejection fraction lower than or equal to 40%. Data were collected between June and December, 2018 by using the demographic questionnaire, questionnaire of knowledge before and after surgery and satisfaction questionnaire. Data were analyzed using descriptive statistic, and paired t-test.
The findings revealed that the patients’ knowledge after receiving the clinical pathway were higher than before implementation with a statistical significance (p < 0.01). Moreover, both patients and nurses were satisfied with the clinical pathway in a high to a very high level. As for clinical outcomes after the operation, it was found that 93.75% of the patients had their fasting blood sugar level lower than or equal to 200 mg/dl, about 83.3% had their systolic blood pressure equal to 130 mmHg or lower, 100% were able to control their emphysema, and 83.3% were able to quit smoking. In addition, telephone follow-ups were conducted during the first week after hospital discharge revealed that CABG patients had sternal wound pain (100%), exertion chest pain (35%), and loss of appetite (22%). Moreover, the three most common problems follow-ups for three weeks after hospital discharge were insomnia and loss of appetite (10%), cough, sternal wound pain (7%) and exertion chest pain (5%).
Based on such finding, the clinical pathway is needed for high risk CABG patients to be prepared before undergoing the surgery, and to ensure continuous care both before and after hospital discharge to ensure desirable clinical outcomes after the surgery.
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