Implementation of Pathway-Based Care for Patients Undergoing Daytime Cholecystectomy

Area of Science:

• Surgical Nursing
• Patient Care Pathways
• Gastrointestinal Surgery

Background:

• Cholelithiasis (gallstones) affects a significant patient population requiring surgical intervention.
• Standard care for cholecystectomy may not fully optimize patient outcomes or minimize surgical stress.
• Pathway-based care models are increasingly explored to enhance efficiency and patient well-being in surgical settings.

Purpose of the Study:

• To evaluate the effectiveness of pathway-based care in patients undergoing daytime cholecystectomy for cholelithiasis.
• To assess the impact of pathway-based care on intraoperative stress response, postoperative complications, and quality of life.

Main Methods:

• A randomized controlled trial involving 258 patients scheduled for daytime cholecystectomy.
• Patients were assigned to either a standard care control group or an intervention group receiving additional pathway-based care.
• Key indicators including body temperature, heart rate, blood oxygen saturation, and blood glucose were monitored at multiple time points (T0, T1, T2).

Main Results:

• The pathway care group demonstrated significantly improved intraoperative SpO2 and stable stress indicators compared to the control group, which showed worsening parameters.
• Pathway care was associated with significantly shorter hospitalization times and reduced rates of postoperative complications such as abdominal pain, incisional infection, and venous thrombosis.
• Patients in the pathway care group reported significantly higher postoperative quality of life scores across all SF-36 dimensions.

Conclusions:

• Pathway-based care significantly enhances operating room nursing quality and efficiency for cholecystectomy patients.
• This care model effectively minimizes intraoperative stress response, leading to fewer postoperative complications.
• Pathway-based care demonstrably improves the overall quality of life for patients recovering from cholecystectomy.