Effect of Nurse Guided Enhanced Recovery Clinical Pathway on Respiratory Infection

NCT06812182 | Completed

• 1 other identifier: Enhanced recovery clinical
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Objectives: Evaluate the effect of a nurse guided enhanced recovery pathway on postoperative respiratory tract infection in Hepatico-Pancreatic -Biliary surgery \[ pre-operative patient counselling for postoperative respiratory physiotherapy techniques and emphasis on perfect training\]. Design: Quasi-experimental study. Setting: The study was conducted in surgical department, operation unit and intensive care unit at AlRajhy liver hospital. Subjects: Sixty patient undergoing hepatobiliary pancreatic surgeries. The sample was divided into two groups; control and study group (30patient each). The control started the first then the study group. Tools: Three tools were used. Tool I: Patient assessment sheet. Tool II: Clinical pathway protocol. Tool III: Clinical outcome evaluation. The control group received tools I and III only while study group received the three tools including clinical pathway protocol \[tool II\].

Conditions

Nurse's Role

Outcome Measures

Primary Outcomes (1)

• postoperative pulmonary infection

  Presence of 3 of the following: tachypnea more than 30/min, expectoration, and hypoxia, respiratory distress

  6 hours postoperatively, day 1, Day 2, and day 3

Study Arms (2)

control

NO INTERVENTION

All the patients admitted to surgical department during the period from early Augusts 2023until the end November 2023 matching the inclusion criteria for this study were included in the control group. The control group contained 30 patients with the same designed criteria. The control group received routine daily care of the hospital. For the control group, the two designed study tools used to assess the patients daily and detect the clinical outcomes of the patients \[tool I and tool III\] only.

study group

EXPERIMENTAL

educational training sessions were provided to care providers including the purpose and the process of implementing the pathway for one week. Following the training thee researchers started to make recruitment and screen for the study group, the researchers received consent from administration to start the data for the study group. The oral and written consent from the patient was also done, to allow the researchers to observe, make daily assessment and manage the patients according to the designed clinical pathway. After completion of the recruitment and screening, all patients admitted to the surgical unit during the five months period from first December 2023 until the end of April 2024 were assessed and managed as study group. The study group also estimated 30 patients that met the inclusion criteria. For the study group, the three designed study tools used to assess the patients daily and detect the clinical outcomes of the patients \[tool I, tool II and tool III\]

Behavioral: nurse guided clinical pathway

Interventions

nurse guided clinical pathway BEHAVIORAL

Educational training sessions were provided to care providers for one week. Pre-operative; counseling and education of patient for chest physiotherapy, using spirometry, bowel preparation, early mobilization and how to predict common complications with learning to cooperate with nurses. Emphasis on patients to co-operate postoperatively was strongly stressed in spite of the pain and weakness. Intra-operative: Optimal fluid management, short acting anesthetics, regional analgesia, opioids-sparing anesthesia, small incisions, avoiding drains, maintaining normothermia, venous thrombo-embolism \[VTE\] prophylaxis and antibiotic prophylaxis were routinely done. Post-operative: Early oral nutrition, optimal fluid management, multimodal non-opioid analgesia, postoperative nausea and vomiting PONV prophylaxis, stimulation of gut motility, early removal of catheters and drains, early mobilization, chest physiotherapy and using spirometry effectively.

study group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• able to communicate
• Patients without vital failure \[renal, hepatic, cardiac\].

You may not qualify if:

• Past history of other organ cancer
• patient refusal

Sponsors & Collaborators

• Assiut University: lead

Study Sites (1)

Faculty of medicine - Assiut university

Asyut, Egypt

Location

Study Officials

• Ayman AM Abouglala

  Assiut University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: SCREENING
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: lecturer

Study Record Dates

• First Submitted: February 1, 2025
• First Posted: February 6, 2025
• Study Start: May 1, 2023
• Primary Completion: August 1, 2024
• Study Completion: December 1, 2024
• Last Updated: February 6, 2025

Record last verified: 2025-02

Locations

EG (1)