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目的研究医院应用临床路径系统对临床路径入组率与完成率的影响,探索在推广临床路径系统过程中遇到问题的应对措施。方法选择2014年1月至2015年6月完成例数≥60例的16个临床路径病种,收集其每个季度的入组率和完成率,采用卡方检验对临床路径系统应用前后6个季度的入组率和完成率进行分析。结果应用临床路径系统后,入组率由系统应用前的70.3%下降至最低值51.5%,完成率由系统应用前的96.3%下降至最低值66.6%。通过实施干预措施后,入组率回升至68.4%,完成率回升至77.5%,经卡方检验,差异均有统计学意义(P<0.05)。结论医院需因地制宜地建立本地化的临床路径系统,同时提高医护人员的依从性,才能使临床路径系统充分发挥管理作用。
Objective To study the impact of hospital clinical pathway system on the enrollment rate and completion rate of clinical pathway and to explore the response to the problems encountered in the promotion of clinical pathway system. Methods From January 2014 to June 2015, 16 clinical pathological cases of ≥60 cases were completed and the enrollment rate and completion rate of each quarter were collected. The chi-square test was used to analyze the clinical pathology system before and after 6 Quarterly enrollment and completion rates were analyzed. Results After applying the clinical pathway system, the enrollment rate decreased from 70.3% before the system application to the lowest value of 51.5%, and the completion rate decreased from 96.3% before the system application to the lowest value of 66.6%. After the implementation of interventions, the enrollment rate rose to 68.4%, and the completion rate rose to 77.5%. There was significant difference (P <0.05) by chi-square test. Conclusion The hospital should establish a localized clinical pathway system according to the local conditions and improve the compliance of medical staff in order to give full play to the management role of the clinical pathway system.