Systematic Reviews and Meta Analysis
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Examining the Impact of Nursing Interventions Based on Clinical Pathways on Patient Outcomes: A Systematic Review

Year 2025, Volume: 8 Issue: 2, 267 - 282, 22.08.2025
https://doi.org/10.54189/hbd.1573090

Abstract

Objective: The purpose of the review is to systematically examine the effects of nursing interventions based on clinical pathways on patient outcomes. This systematic review provides evidence for nurses, who are members of a professional profession, to plan, develop, implement and evaluate clinical pathways. The main research question is “how do nurses, who are an important team member in the studies conducted, proceed in clinical pathway-based care?”
Method: In the systematic review, studies from 2002 to 2024 were searched in MEDLINE, Scopus databases and the National Thesis Center. The search was conducted using the English keywords “clinical pathways’’, “care pathways’’, “care map’’, “clinical paths’’, “critical paths’’, “nursing care’’. As a result of the search, 877 articles were reached. 21 articles, whose eligibility was evaluated according to the inclusion criteria, were included in this review.
Findings: Nurses were team leaders responsible for the development, implementation or evaluation of the clinical pathway as researchers in 57% (n=12) of the studies reviewed.Other clinical pathway duties of nurses within the multidisciplinary team are specialized tasks such as data collection, retrospective review of health records, organization of expert panels, creation of tumor records, home visits, independent clinical pathway implementation and decision-making for nursing care, communication, supervision, quality control, opinion reporting, case manager and coordination manager.
Conclusion: The results obtained within the framework of a systematic review of studies examining the effects of nursing interventions based on clinical pathways on patient outcomes provided an opportunity to examine in detail the date, location, patient sample, the way clinical pathways were developed, research outputs and nurses' work items. This systematic review provides evidence to empower nurses to respond to the increasing quality expectations in health care.

References

  • Alona I, Harahap J, Aribi A, Ikhsan R, Siregar M. (2021). Assessment of healthcare professional’s knowledge, skills, motivation, and commitment to clinical pathways implementation. Open Access Macedonian Journal of Medical Sciences, 9(E), 540-546.
  • Askari M, Tam J, Klundert J. (2021). The effectiveness of clinical pathway software in inpatient settings: a systematic review. International Journal of Medical Informatics, 147. doi:10.1016/j.ijmedinf.2020.104374
  • Bjurling-Sjöberg P, Wadensten B, Pöder U, Jansson I, Nordgren L. (2018). Struggling for a feasible tool – the process of implementing a clinical pathway in intensive care: a grounded theory study. BMC Health Services Research, 18(1), 1-15.
  • Casp. (2024). Critical apprasial skill programme. (Erişim tarihi:11.03.2024), https://casp-uk.net/casp-tools-checklists/
  • Curtis K, Murphy M, Kourouche S, Hughes D, Casey L, Gawthorne J, et al. (2024). Designing a standardised emergency nurse career pathway for use across rural, regional and metropolitan New South Wales, Australia: a consensus process. Australas Emerg Care, 27(3),198-206. doi: 10.1016/j.auec.2024.03.002.
  • De Allegri M, Schwarzbach M, Loerbroks A, Ronellenfitsch U. (2011). Which factors are important for the successful development and implementation of clinical pathways? A qualitative study. BMJ Quality & Safety, 20, 203-208.
  • De Bleser L, Depreitere R, Waele K, Vanhaecht K, Vlayen J, Sermeus W, et al. (2006). Defining pathways. Journal of Nursing Management, 14(7), 553-563.
  • Dewi P, Sandra C, Witcahyo E. (2019). Resources required in clinical pathway for typhoid fever treatment at kaliwates genneral hospital in 2017. J Adm Kesehatan Indones, 7(2), 155-161.
  • EPA. (2024, March 3). European Pathway Association. https://e-p-a.org/care-pathways/
  • Evans J, Horn K, Cowan D, Brunero S. (2020). Development of a clinical pathway for screening and integrated care of eating disorders in a rural substance use treatment setting. International Journal of Mental Health Nursing, 29(5), 878-887.
  • Fernández-Peña R, Ortego-Maté C, Amo-Setién F, Silió-García T, Casasempere-Satorres A, Sarabia-Cobo C. (2021). Implementing a care pathway for complex chronic patients from a nursing perspective: a qualitative study. International Journal of Environmental Research and Public Health, 18(12), 6324.
  • Forrester M, Breitenfeld L, Castelo-Branco M, Aperta J. (2023). Identification of an oncological clinical pathway through questionnaires to health professionals. BMC Health Serv Res, 23(1), 1011. doi: 10.1186/s12913-023-09964-w.
  • Gendron K, Lai S, Weinstein G, Chalian A, Husbands J, Wolf P, et al. (2002). Clinical care pathway for head and neck cancer: a valuable tool for decreasing resource utilization. Archives of Otolaryngology–Head & Neck Surgery, 128(3), 258-262.
  • Hamaker ME, Wildiers H, Ardito V, Arsandaux J, Barthod-Malat A, Davies P, et al. (2024). Study protocol for two stepped-wedge interventional trials evaluating the effects of holistic information technology-based patient-oriented management in older multimorbid patients with cancer: The Geronte trials. J Geriatr Oncol, 215(4), 101761. doi: 10.1016/j.jgo.2024.101761.
  • Huang H, Yu S, Zheng J. (2022). The clinical nursing pathway on prevention of catheter slippage with ıntensive care unit patients: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 8: 1144888. doi:10.1155/2022/1144888
  • Hussain Z, Lim M, Stojkovic S. (2017). Role of clinical pathway in improving the quality of care for patients with faecal incontinence: A randomised trial. World Journal of Gastrointestinal Pharmacology and Therapeutics, 8(1), 81.
  • Kebapcı A, Kanan N. (2018). Effects of nurse‐led clinical pathway in coronary artery bypass graft surgery: A quasi‐experimental study. Journal of clinical Nursing, 27(5-6), 980-988.
  • Kwon H, Lee J, Woo J, Lim W, Moon B, Paik N. (2018). Efficacy of a clinical pathway for patients with thyroid cancer. Head&Neck, 40(9), 1909-1916.
  • Lauck SB, Yu M, Bancroft C, Borregaard B, Polderman J, Stephenson AL, et al. (2023). Early mobilization after transcatheter aortic valve implantation: observational cohort study. Eur J Cardiovasc Nurs, 12, 23(3), 296-304. doi: 10.1093/eurjcn/zvad081
  • Li J, Xiang L, Li Q, Liu J, Pan J. (2024). Impact of clinical pathway implementation satisfaction, work engagement, and hospital-patient relationship on quality of care in Chinese nurses. Int Nurs Rev, 72 (1): e12981. doi: 10.1111/inr.12981.
  • Liu C, Wang X, Zhang K, Hao G, Han W, Tian Y. (2021). Study on clinical nursing pathway to promote the effective implementation of sepsis bundle in septic shock. European Journal of Medical Research, 26(1), 1-6.
  • Martino D, Nosratmirshekarlou E, Cothros N, Medina Escobar A, Goodarzi Z. (2023). Development of a new care pathway for depression and anxiety in adult-onset ısolated dystonia. Mov Disord Clin Pract, 30, 10(3), 415-426. doi: 10.1002/mdc3.13655.
  • MeSH. (2024). Medical Subject Headings. (Erişim tarihi:03.10.2024), https://meshb.nlm.nih.gov/record/ui?ui=D019091
  • Page MJ. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev, 10(1), 89. doi:10.1186/s13643-021-01626-4
  • PRISMA. (2024). Preferred Reporting Items for Systematic Reviews and Meta-Analyses. (Erişim tarihi: 01.03.2024), http://www.prisma-statement.org/?AspxAutoDetectCookieSupport=1
  • Romiti G, Pastori D, Rivera-Caravaca J, Ding W, Gue Y, Menichelli D, et al. (2022). Adherence to the 'atrial fibrillation better care' pathway in patients with atrial fibrillation: ımpact on clinical outcomes-a systematic review and meta-analysis of 285,000 Patients. Thromb Haemost, 122(3), 406-414. doi:10.1055/a-1515-9630
  • Rosentain A, O’ Daniel M. (2005). Disruptive behaviour and clinical outcomes: Perceptions of nurses and physicians. Am J Nurs, 105(1), 54-64.
  • Rotter T, Kinsman L, James E, Machotta A, Gothe H, Willis J, et al. (2010). Clinical pathways: Effects on professional practice, patient outcomes, length of stay and hospital costs. Cochrane Database of Systematic Reviews, (3), Article No. CD006632. https://doi.org/10.1002/14651858.CD006632.pub2
  • Rotter T, Kinsman L, James E, Machotta A, Willis J, Snow P, et al. (2012). Have we drawn the wrong conclusions about the value of care pathways? ıs a cochrane review appropriate? response to the commentary article published by kris vanhaecht et al. Evaluation & the Health Professions, 35(1), 43-46.
  • Sacco A, Coffey C, Sanghvi P, Rubio G, Califano J, Athas J, et al. (2018). Development of care pathways to standardize and optimally integrate multidisciplinary care for head and neck cancer. Oncology Issues, 33(6), 28-44.
  • Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopaedic Nursing, 36(1), 12–25. https://doi.org/10.1097/NOR.0000000000000308
  • Santamaria N, Conners A, Osteraas J, Ham J, Boodram B. (2004). A prospective cohort study of the effectiveness of clinical pathways for the in-patient management of acute exacerbation of chronic obstructive pulmonary disease (COPD). Collegian, 11(1), 12-16.
  • Semlitsch T, Stigler F, Jeitler K, Horvath K, Siebenhofer A. (2019). Management of overweight and obesity in primary care-A systematic overview of international evidence-based guidelines. Obes Rev, 20(9), 1218-1230. doi:10.1111/obr.12889
  • Sjoerdsma M, Bongaerts T, van Lente L, Kamps, A. (2020). Nurse-driven clinical pathway based on an ınnovative asthma score reduces admission time for children. Pediatr Qual Saf, 5(5), 344.
  • Vanhaecht, K., De Witte, K., & Sermeus, W. (2007). The care process organisation triangle: A framework to better understand how pathways work. Journal of Integrated Care Pathways, 11, 1–8.
  • Wen A, Meng J, Luo G, Wen G, Cui W, Tang S, Zhang Y. (2024). Factors contributing to hospitalization expenditures for patients with COPD in Yunnan Province, China: a path analysis. BMC Health Serv Res, 28, 24(1), 1496. doi: 10.1186/s12913-024-11874-4.
  • Wendel SK, Bookman K, Holmes M, Wiler JL. (2003). Successful implementation of workflow-embedded clinical pathways during the Covid 19 Pandemic. Qual Manag Health Care, 32(3), 205-210. doi: 10.1097/QMH.0000000000000408.
  • World Health Organization (WHO). (2017). Patient safety: Making health care safer. (Erişim tarihi: 03.03.2024), https://www.who.int/publications/i/item/WHO-HIS-SDS-2017.11
  • Zhang L, Shen T, Zhou Y, Xie X, Wang J, Gao H. (2004). Multidisciplinary management based on clinical nursing pathway model for the treatment of hypertensive intracerebral hemorrhage: A randomized controlled trial. Medicine (Baltimore), 103(12), e37644. doi: 10.1097/MD.0000000000037644.
  • Zhang X, Wang H. (2022). Application effect analysis of clinical nursing pathway in the care of neonatal hypoxic-ischemic encephalopathy. Computational and Mathematical Methods in Medicine, Article ID 9872026 doi: 10.1155/2023/9872026.

Klinik Yollar ile Temellenen Hemşirelik Müdahalelerinin Hasta Sonuçları Üzerinde Etkisinin İncelenmesi: Sistematik Derleme

Year 2025, Volume: 8 Issue: 2, 267 - 282, 22.08.2025
https://doi.org/10.54189/hbd.1573090

Abstract

Amaç: Derlemenin amacı klinik yollar ile temellenen hemşirelik müdahalelerinin hasta sonuçları üzerinde etkisinin sistematik olarak incelenmesidir. Bu sistematik derleme de profesyonel bir meslek üyesi olan hemşirelerin klinik yolları planlaması, geliştirmesi, uygulaması ve değerlendirmesi için kanıtlar sunulmuştur. Temel araştırma sorusu “yapılan araştırmalar içerisinde önemli bir ekip üyesi olan hemşirelerin klinik yollar ile temellenen bakımda nasıl bir yol aldığıdır.
Yöntem: Sistematik derlemede 2002 yılından 2024 yılına kadar olan çalışmalar MEDLINE, Scopus veri tabanlarında ve Ulusal Tez Merkezinde tarandı. Tarama İngilizce dilinde “clinical pathways’’, “care pathways’’, “care map’’, “clinical paths’’, “critical paths’’, “nursing care’’ anahtar kelimeleri kullanılarak yapıldı. Yapılan tarama sonucunda 877 makaleye ulaşılmıştır. Araştırmaya dahil edilme kriterlerine göre uygunlukları değerlendirilen 21 makale bu derleme kapsamına alınmıştır.
Bulgular: Hemşireler incelenen araştırmaların % 57’sinde (n=12) araştırmacı olarak klinik yolun geliştirilmesi, uygulanması veya değerlendirilmesinden sorumlu ekip lideriydi. Multidisipliner ekibin içerisinde yer alan hemşirelerin diğer klinik yol görevleri veri toplama, sağlık kayıtlarını retrospektif olarak inceleme, uzman panelleri düzenleme, tümör kayıtları oluşturma, ev ziyaretleri, bağımsız klinik yol uygulamalarına ve hemşirelik bakımına karar verme, iletişim, denetleme, kalite kontrolü, görüş bildirme, vaka yöneticisi ve koordinasyon yöneticisi gibi özelleşmiş işlerdir.
Sonuç: Klinik yollar ile temellenen hemşirelik müdahalelerinin hasta sonuçları üzerinde etkisini inceleyen araştırmaların sistematik olarak incelenmesi çerçevesinde elde edilen sonuçlar yapılan araştırmaların tarihini, yerini, hasta örneklemini, klinik yolların geliştirilme şeklini, araştırma çıktılarını ve hemşirelerin iş kalemlerini ayrıntılı inceleme fırsatı sunmuştur. Bu sistematik derleme sağlık bakımında artan kalite beklentisine yanıt oluşturabilmek için hemşireleri güçlendirme yolunda kanıt oluşturmaktadır.

References

  • Alona I, Harahap J, Aribi A, Ikhsan R, Siregar M. (2021). Assessment of healthcare professional’s knowledge, skills, motivation, and commitment to clinical pathways implementation. Open Access Macedonian Journal of Medical Sciences, 9(E), 540-546.
  • Askari M, Tam J, Klundert J. (2021). The effectiveness of clinical pathway software in inpatient settings: a systematic review. International Journal of Medical Informatics, 147. doi:10.1016/j.ijmedinf.2020.104374
  • Bjurling-Sjöberg P, Wadensten B, Pöder U, Jansson I, Nordgren L. (2018). Struggling for a feasible tool – the process of implementing a clinical pathway in intensive care: a grounded theory study. BMC Health Services Research, 18(1), 1-15.
  • Casp. (2024). Critical apprasial skill programme. (Erişim tarihi:11.03.2024), https://casp-uk.net/casp-tools-checklists/
  • Curtis K, Murphy M, Kourouche S, Hughes D, Casey L, Gawthorne J, et al. (2024). Designing a standardised emergency nurse career pathway for use across rural, regional and metropolitan New South Wales, Australia: a consensus process. Australas Emerg Care, 27(3),198-206. doi: 10.1016/j.auec.2024.03.002.
  • De Allegri M, Schwarzbach M, Loerbroks A, Ronellenfitsch U. (2011). Which factors are important for the successful development and implementation of clinical pathways? A qualitative study. BMJ Quality & Safety, 20, 203-208.
  • De Bleser L, Depreitere R, Waele K, Vanhaecht K, Vlayen J, Sermeus W, et al. (2006). Defining pathways. Journal of Nursing Management, 14(7), 553-563.
  • Dewi P, Sandra C, Witcahyo E. (2019). Resources required in clinical pathway for typhoid fever treatment at kaliwates genneral hospital in 2017. J Adm Kesehatan Indones, 7(2), 155-161.
  • EPA. (2024, March 3). European Pathway Association. https://e-p-a.org/care-pathways/
  • Evans J, Horn K, Cowan D, Brunero S. (2020). Development of a clinical pathway for screening and integrated care of eating disorders in a rural substance use treatment setting. International Journal of Mental Health Nursing, 29(5), 878-887.
  • Fernández-Peña R, Ortego-Maté C, Amo-Setién F, Silió-García T, Casasempere-Satorres A, Sarabia-Cobo C. (2021). Implementing a care pathway for complex chronic patients from a nursing perspective: a qualitative study. International Journal of Environmental Research and Public Health, 18(12), 6324.
  • Forrester M, Breitenfeld L, Castelo-Branco M, Aperta J. (2023). Identification of an oncological clinical pathway through questionnaires to health professionals. BMC Health Serv Res, 23(1), 1011. doi: 10.1186/s12913-023-09964-w.
  • Gendron K, Lai S, Weinstein G, Chalian A, Husbands J, Wolf P, et al. (2002). Clinical care pathway for head and neck cancer: a valuable tool for decreasing resource utilization. Archives of Otolaryngology–Head & Neck Surgery, 128(3), 258-262.
  • Hamaker ME, Wildiers H, Ardito V, Arsandaux J, Barthod-Malat A, Davies P, et al. (2024). Study protocol for two stepped-wedge interventional trials evaluating the effects of holistic information technology-based patient-oriented management in older multimorbid patients with cancer: The Geronte trials. J Geriatr Oncol, 215(4), 101761. doi: 10.1016/j.jgo.2024.101761.
  • Huang H, Yu S, Zheng J. (2022). The clinical nursing pathway on prevention of catheter slippage with ıntensive care unit patients: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 8: 1144888. doi:10.1155/2022/1144888
  • Hussain Z, Lim M, Stojkovic S. (2017). Role of clinical pathway in improving the quality of care for patients with faecal incontinence: A randomised trial. World Journal of Gastrointestinal Pharmacology and Therapeutics, 8(1), 81.
  • Kebapcı A, Kanan N. (2018). Effects of nurse‐led clinical pathway in coronary artery bypass graft surgery: A quasi‐experimental study. Journal of clinical Nursing, 27(5-6), 980-988.
  • Kwon H, Lee J, Woo J, Lim W, Moon B, Paik N. (2018). Efficacy of a clinical pathway for patients with thyroid cancer. Head&Neck, 40(9), 1909-1916.
  • Lauck SB, Yu M, Bancroft C, Borregaard B, Polderman J, Stephenson AL, et al. (2023). Early mobilization after transcatheter aortic valve implantation: observational cohort study. Eur J Cardiovasc Nurs, 12, 23(3), 296-304. doi: 10.1093/eurjcn/zvad081
  • Li J, Xiang L, Li Q, Liu J, Pan J. (2024). Impact of clinical pathway implementation satisfaction, work engagement, and hospital-patient relationship on quality of care in Chinese nurses. Int Nurs Rev, 72 (1): e12981. doi: 10.1111/inr.12981.
  • Liu C, Wang X, Zhang K, Hao G, Han W, Tian Y. (2021). Study on clinical nursing pathway to promote the effective implementation of sepsis bundle in septic shock. European Journal of Medical Research, 26(1), 1-6.
  • Martino D, Nosratmirshekarlou E, Cothros N, Medina Escobar A, Goodarzi Z. (2023). Development of a new care pathway for depression and anxiety in adult-onset ısolated dystonia. Mov Disord Clin Pract, 30, 10(3), 415-426. doi: 10.1002/mdc3.13655.
  • MeSH. (2024). Medical Subject Headings. (Erişim tarihi:03.10.2024), https://meshb.nlm.nih.gov/record/ui?ui=D019091
  • Page MJ. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev, 10(1), 89. doi:10.1186/s13643-021-01626-4
  • PRISMA. (2024). Preferred Reporting Items for Systematic Reviews and Meta-Analyses. (Erişim tarihi: 01.03.2024), http://www.prisma-statement.org/?AspxAutoDetectCookieSupport=1
  • Romiti G, Pastori D, Rivera-Caravaca J, Ding W, Gue Y, Menichelli D, et al. (2022). Adherence to the 'atrial fibrillation better care' pathway in patients with atrial fibrillation: ımpact on clinical outcomes-a systematic review and meta-analysis of 285,000 Patients. Thromb Haemost, 122(3), 406-414. doi:10.1055/a-1515-9630
  • Rosentain A, O’ Daniel M. (2005). Disruptive behaviour and clinical outcomes: Perceptions of nurses and physicians. Am J Nurs, 105(1), 54-64.
  • Rotter T, Kinsman L, James E, Machotta A, Gothe H, Willis J, et al. (2010). Clinical pathways: Effects on professional practice, patient outcomes, length of stay and hospital costs. Cochrane Database of Systematic Reviews, (3), Article No. CD006632. https://doi.org/10.1002/14651858.CD006632.pub2
  • Rotter T, Kinsman L, James E, Machotta A, Willis J, Snow P, et al. (2012). Have we drawn the wrong conclusions about the value of care pathways? ıs a cochrane review appropriate? response to the commentary article published by kris vanhaecht et al. Evaluation & the Health Professions, 35(1), 43-46.
  • Sacco A, Coffey C, Sanghvi P, Rubio G, Califano J, Athas J, et al. (2018). Development of care pathways to standardize and optimally integrate multidisciplinary care for head and neck cancer. Oncology Issues, 33(6), 28-44.
  • Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopaedic Nursing, 36(1), 12–25. https://doi.org/10.1097/NOR.0000000000000308
  • Santamaria N, Conners A, Osteraas J, Ham J, Boodram B. (2004). A prospective cohort study of the effectiveness of clinical pathways for the in-patient management of acute exacerbation of chronic obstructive pulmonary disease (COPD). Collegian, 11(1), 12-16.
  • Semlitsch T, Stigler F, Jeitler K, Horvath K, Siebenhofer A. (2019). Management of overweight and obesity in primary care-A systematic overview of international evidence-based guidelines. Obes Rev, 20(9), 1218-1230. doi:10.1111/obr.12889
  • Sjoerdsma M, Bongaerts T, van Lente L, Kamps, A. (2020). Nurse-driven clinical pathway based on an ınnovative asthma score reduces admission time for children. Pediatr Qual Saf, 5(5), 344.
  • Vanhaecht, K., De Witte, K., & Sermeus, W. (2007). The care process organisation triangle: A framework to better understand how pathways work. Journal of Integrated Care Pathways, 11, 1–8.
  • Wen A, Meng J, Luo G, Wen G, Cui W, Tang S, Zhang Y. (2024). Factors contributing to hospitalization expenditures for patients with COPD in Yunnan Province, China: a path analysis. BMC Health Serv Res, 28, 24(1), 1496. doi: 10.1186/s12913-024-11874-4.
  • Wendel SK, Bookman K, Holmes M, Wiler JL. (2003). Successful implementation of workflow-embedded clinical pathways during the Covid 19 Pandemic. Qual Manag Health Care, 32(3), 205-210. doi: 10.1097/QMH.0000000000000408.
  • World Health Organization (WHO). (2017). Patient safety: Making health care safer. (Erişim tarihi: 03.03.2024), https://www.who.int/publications/i/item/WHO-HIS-SDS-2017.11
  • Zhang L, Shen T, Zhou Y, Xie X, Wang J, Gao H. (2004). Multidisciplinary management based on clinical nursing pathway model for the treatment of hypertensive intracerebral hemorrhage: A randomized controlled trial. Medicine (Baltimore), 103(12), e37644. doi: 10.1097/MD.0000000000037644.
  • Zhang X, Wang H. (2022). Application effect analysis of clinical nursing pathway in the care of neonatal hypoxic-ischemic encephalopathy. Computational and Mathematical Methods in Medicine, Article ID 9872026 doi: 10.1155/2023/9872026.
There are 40 citations in total.

Details

Primary Language Turkish
Subjects Public Health Nursing, Nursing (Other)
Journal Section Systematic Reviews and Meta Analysis
Authors

Arife Gür Boz 0000-0002-3103-0558

Gülengül Mermer 0000-0002-0566-5656

Publication Date August 22, 2025
Submission Date October 24, 2024
Acceptance Date January 23, 2025
Published in Issue Year 2025 Volume: 8 Issue: 2

Cite

APA Gür Boz, A., & Mermer, G. (2025). Klinik Yollar ile Temellenen Hemşirelik Müdahalelerinin Hasta Sonuçları Üzerinde Etkisinin İncelenmesi: Sistematik Derleme. Hemşirelik Bilimi Dergisi, 8(2), 267-282. https://doi.org/10.54189/hbd.1573090