THE IMPLEMENTATION OF ACUTE APPENDICITIS CLINICAL PATHWAY TOWARD AVERAGE LENGTH OF STAY

Authors

  • Al Razi Sena Department of Health Services and Information, Vocational Schools, Universitas Gadjah Mada Yogyakarta, 555281, Indonesia
  • Sri Setiyarini Department of Basic Nursing and Emergencies, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada Yogyakarta, 555281, Indonesia

DOI:

https://doi.org/10.20319/lijhls.2020.62.1122

Keywords:

Clinical Pathway, Acute Appendicitis, Average Length of Stay

Abstract

Acute appendicitis is a gastrointestinal disease that the incidence of it was increased in Indonesia from 566132 people in 2009 became 621435 in 2010. Cases of acute appendicitis were continued to increase every year at Condong Catur Hospital. A clinical pathway ideally suited to the management of common surgical conditions with well-defined outcomes, such as appendicitis. Implementation of the clinical pathway as clinical guidance needed to be measured to find out the impact on the outcome of the patient. This study aims to find out a significant impact of acute appendicitis clinical pathway toward the average length of stay. This study used a cross-sectional design, carried out at Condong Catur Hospital. Data were collected from the medical records of patients, both before (52 medical records) and after (50 medical records) the clinical pathway was implemented. Frequency distribution result was performed using descriptive statistics. The chi-square test was performed to find out the significant difference between variables. This study noted the majority of acute appendicitis patient occurred at 15-24 years old and male sex. Majority of the medical records of the patient is without clinical pathway. Most of the medical records with the clinical pathway are incomplete in filling on psychosocial counselling, education and communication with patient and family, and discharge planning. The mean of average length decrease from 3.52 days become 2.36 days. There is a significant difference between the implementation of a clinical pathway toward AvLOS with p-value = 0.000. There is a significant relationship between the implementation of clinical pathway appendicitis acute toward reduced of AvLOS. The hospital needs to maintain compliance in the filling of clinical pathway among physicians through regular monitoring or socialization.

References

Arifuddin, A., Salmawati, L., & Prasetyo, A. (2017). Faktor Risiko Kejadian Apendisitis di Bagian Rawat Inap Rumah Sakit Umum Anutapura Palu. Jurnal Preventif: Kesehatan Masyarakat, 8(1):26-33

Ahmad, T., Ali, Z., Ali, A., & Anjum, S. (2010). Perforated Appendix: Contributing Factors. JUMDC, 1(2):11-16.

Almond, S. L., Roberts, M., Joesbury, V., Mon, S., Smith, J., Ledwidge, N., … Kenny, S. E. (2008). It is not what you do, it is the way that you do it: impact of a care pathway for appendicitis. Journal of Pediatric Surgery, 43(2), 315–319. https://doi.org/10.1016/j.jpedsurg.2007.10.019

Franke, T. M., Ho, T., & Christie, C. A. (2012). The Chi-Square Test. American Journal of Evaluation, 33(3), 448–458. https://doi.org/10.1177/1098214011426594

Gearhart, S., & Silen, W. (2013). In: Longo D, Fauci A, editors. Harrison Gastroenterologi & Hepatologi. Jakarta: EGC.

He, X. Y., Bundorf, M. K., Gu, J. J., Zhou, P., & Xue, D. (2015). Compliance with clinical pathways for inpatient care in Chinese public hospitals. BMC Health Services Research, 15(1), 459. https://doi.org/10.1186/s12913-015-1121-8

Indri, U., Karim, D., & Elita, V. (2014). Hubungan Antara Nyeri, Kecemasan Dan Lingkungan Dengan Kualitas Tidur Pada Pasien Post Operasi Apendisitis. Jurnal Online Mahasiswa Program Studi Ilmu Keperawatan. 1 (2): 1-8.

Lee, J.H., Choi, J.B., & Park, Y. (2010). The Epidemiology of Appendicitis and Appendectomy in South Korea : National Registry Data. Journal of Epidemiology, 20(2): 97-105. https://doi.org/10.2188/jea.JE20090011

Molloy, I. B., Martin, B. I., Moschetti, W. E., & Jevsevar, D. S. (2017). Effects of the Length of Stay on the Cost of Total Knee and Total Hip Arthroplasty from 2002 to 2013. The Journal of Bone and Joint Surgery, 99(5), 402–407. https://doi.org/10.2106/JBJS.16.00019

Panella, M. (2003). Reducing clinical variations with clinical pathways: do pathways work? International Journal for Quality in Health Care, 15(6), 509–521. https://doi.org/10.1093/intqhc/mzg057

Pasaribu, I. C. (2010). Karakteristik Penderita Apendisitis di RSUP H. Adam Malik Medan. Thesis. Fakultas Kedokteran Universitas Sumatera Utara.

Reid, L. E. M., Dinesen, L. C., Jones, M. C., Morrison, Z. J., Weir, C. J., & Lone, N. I. (2016). The effectiveness and variation of acute medical units: a systematic review. International Journal for Quality in Health Care, 28(4), 433–446. https://doi.org/10.1093/intqhc/mzw056

Rotter, T., Kinsman, L., James, E. L., Machotta, A., Gothe, H., Willis, J., … Kugler, J. (2010). Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD006632.pub2

Rotter, T., Kugler, J., Koch, R., Gothe, H., Twork, S., van Oostrum, J. M., & Steyerberg, E. W. (2008). A systematic review and meta-analysis of the effects of clinical pathways on length of stay, hospital costs and patient outcomes. BMC Health Services Research, 8(1), 265. https://doi.org/10.1186/1472-6963-8-265

Schrijvers, G., Hoorn, A. van, & Huiskes, N. (2012). The Care Pathway Concept: concepts and theories: an introduction. International Journal of Integrated Care, 12(6). https://doi.org/10.5334/ijic.812

Thomas, G. A., Lahunduitan, I., & Tangkilisan, A. (2016). Angka Kejadian Apendisitis Di Rsup Prof. Dr. R. D. Kandou Manado Periode Oktober 2012 – September 2015. E-CliniC, 4(1). https://doi.org/10.35790/ecl.4.1.2016.10960

Wei, P.-L., Chen, C.-S., Keller, J. J., & Lin, H.-C. (2012). Monthly variation in acute appendicitis incidence: A 10-year nationwide population-based study. Journal of Surgical Research, 178(2), 670–676. https://doi.org/10.1016/j.jss.2012.06.034

Willis, B., Kim, L. T., Anthony, T., Bergen, P. C., Nwariaku, F., & Turnage, R. H. (2000). A Clinical Pathway for Inguinal Hernia Repair Reduces Hospital Admissions. Journal of Surgical Research, 88(1), 13–17. https://doi.org/10.1006/jsre.1999.5768

Zhu, L., Li, J., Li, X. K., Feng, J. Q., & Gao, J. M. (2014). Impact of a clinical pathway on hospital costs, length of stay and early outcomes after hepatectomy for hepatocellular carcinoma. Asian Pacific Journal of Cancer Prevention, 15(13), 5389–5393. https://doi.org/10.7314/APJCP.2014.15.13.5389

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Published

2020-07-15

How to Cite

Sena, A. R., & Setiyarini, S. (2020). THE IMPLEMENTATION OF ACUTE APPENDICITIS CLINICAL PATHWAY TOWARD AVERAGE LENGTH OF STAY. LIFE: International Journal of Health and Life-Sciences, 6(2), 11–22. https://doi.org/10.20319/lijhls.2020.62.1122