Title

Post operative pediatric appendicitis nurse-driven discharge: Patient outcomes and nursing perspectives.

Document Type

Article

Publication Date

4-20-2020

Publication Title

American journal of surgery

Abstract

BACKGROUND: Nurse-driven discharge pathways following pediatric appendectomies have proven effective in children's hospitals; studies in general hospital settings are lacking. Additionally, despite the central role of nursing in such pathways, nursing perspectives aren't investigated in the literature.

METHODS: Data from all pediatric acute uncomplicated appendicitis patients who underwent laparoscopic appendectomy in the 12 months following institution of a nurse-driven discharge pathway (intervention, n = 67) were compared to those treated in the preceding year (control, n = 64). Surveys on the pathway were distributed to pediatric ward nurses.

RESULTS: Postoperative length of stay (POLOS) decreased by 37% in the intervention group, about 6 h, (0.44 days ± 0.22 vs 0.7 days ± 0.27, p-value 0.0001), without a significant increase in related readmissions. Same day discharges increased from 10.9% to 46.3%, (P-value 0.0001). Nurse surveys revealed a high approval of the pathway (7-10/10) and yielded valuable feedback.

CONCLUSION: A nurse-driven discharge pathway decreased POLOS without increasing readmission following pediatric laparoscopic appendectomy in a general hospital setting. Valuable insight into nursing perspectives on this pathway was acquired.

Clinical Institute

Women & Children

Clinical Institute

Digestive Health

Department

Pediatrics

Department

Nursing

Department

Surgery

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