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The Use of Clinical Pathways in Patients with Thoracic Injuries

Barker, Tina M
http://rave.ohiolink.edu/etdc/view?acc_num=kent1586891718248184

Abstract Details

2020, DNP, Kent State University, College of Nursing.
As a result of pulmonary complications, thoracic trauma is associated with high morbidity and mortality rates. Uncontrolled pain, poor inspiratory effort, and nonproductive cough contribute to pulmonary complications without early intervention. Pulmonary complications are responsible for high hospital and intensive care unit (ICU) readmission rates and lengths of stay (LOS). The implementation of a clinical pathway can reduce these variables through standardization of care. A study was conducted over six months to measure the effects of implementing a rib fracture management clinical pathway in a rural Level II trauma hospital on incidence rates of acute respiratory failure, ICU readmission, and total hospital and ICU length of stay. Results were compared six months pre- and post-clinical pathway. Patient data were obtained from TQIP (Trauma Quality Improvement Program) reports prior to the clinical pathway intervention in 2017 (n = 40) and after the intervention in 2018 (n = 53). Patients were predominantly White (92.5%, 86.6%) males (67.5%, 69.8%) ranging in age from 18 to 88 (mean age = 56). The ICU LOS was also statistically comparable across the categories, t(91)=.11, p=.92. The mean LOS in the hospital was slightly higher among the 2017 (M=6.8 SD=6.0) sample than among the 2018 sample (M=6.3 SD=5.1), the difference did not reach statistical significance, t(91)=.12, p=.25. Similarly, there were no significant differences between the samples in terms of readmission to ICU rates, χ2 (1) =1.46, p=.23, or respiratory failure rates, χ2 (1) =1.64, p=.20. This project identified significant gaps in rib fracture management, in addition to a need to achieve organization-wide goal alignment in order to promote positive patient outcomes.
Louise Knox (Committee Chair)
Lisa Onesko (Committee Member)
Tracey Motter (Committee Member)
40 p.
Nursing
clinical pathways; rib fracture management; pain management; chest physiotherapy; ICU re-admissions; ICU costs

Recommended Citations

Citations

  • Barker, T. M. (2020). The Use of Clinical Pathways in Patients with Thoracic Injuries [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1586891718248184

    APA Style (7th edition)

  • Barker, Tina. The Use of Clinical Pathways in Patients with Thoracic Injuries. 2020. Kent State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=kent1586891718248184.

    MLA Style (8th edition)

  • Barker, Tina. "The Use of Clinical Pathways in Patients with Thoracic Injuries." Doctoral dissertation, Kent State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=kent1586891718248184

    Chicago Manual of Style (17th edition)

kent1586891718248184
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© 2020, all rights reserved.
This open access ETD is published by Kent State University and OhioLINK.